Doyle J R
Division of Orthopaedics, John A. Burns School of Medicine, University of Hawaii-Manoa, Honolulu.
J Hand Surg Am. 1990 Jan;15(1):78-82. doi: 10.1016/s0363-5023(09)91109-1.
The transverse fibers of the palmar aponeurosis are attached by vertical septa to the underlying transverse metacarpal ligament and thus form a pulley over the flexor tendons. It is a constant and substantial retinacular structure that overlays the synovial sheath. Because of its proven function, position and breaking strength, I believe it should be considered part of the flexor tendon pulley system.
