Surgical repair of multiple pulley injuries--evaluation of a new combined pulley repair.

PURPOSE

We report on a combined repair of multiple annular pulley tears using 1 continuous palmaris longus tendon graft to restore strength and function.

METHODS

We treated 6 rock climbers with grade 4 pulley injuries (multiple pulley injuries) using the combined repair technique and re-evaluated them after a mean of 28 months.

RESULTS

All patients had excellent Buck-Gramcko scores; the functional outcome was good in 4, satisfactory in 1, and fair in 1. The sport-specific outcome was excellent in 5 and satisfactory in 1. Proximal interphalangeal joint flexion deficit slightly increased in 1 patient and remained the same in the other 5. Climbing level after the injury was the same as before in 4 and decreased slightly in 2 climbers.

CONCLUSIONS

The technique is effective with good results and has since become our standard treatment. Nevertheless, it is limited in patients with flexion contracture of the proximal interphalangeal joint.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.