Department of Hand and Reconstructive Surgery, La Timone Hospital, Assistance Publique des Hôpitaux de Marseille, 264 Rue Saint Pierre, 13005 Marseille, France.
Aix-Marseille University, CNRS, ISM, 163 Avenue de Luminy, CP 910, 13288 Marseille Cedex 09, France.
Hand Surg Rehabil. 2021 Oct;40(5):643-649. doi: 10.1016/j.hansur.2021.04.007. Epub 2021 Apr 24.
Sport climbing is increasingly popular and consultations by climbers in hand surgery departments are on the increase. The pathologies related to this sport concern essentially the pulley system, tendons being rarely affected. We report the case of a male climber who presented an atypical rupture of the flexor superficialis tendon in his left middle finger sustained when using an atypical climbing grip technique: the "hook grip". This consists in extension of the metacarpophalangeal joints and maximal flexion of the proximal interphalangeal joints with force exerted only on middle phalanx of the middle finger. A biomechanical analysis using finger musculoskeletal modeling was performed to compare the hook grip to other grips, and the patient's recovery performance was assessed. Adapted functional treatment with physiotherapy seems to have been a good option for the treatment of this atypical lesion since the patient recovered normal use of his finger in daily life. He recovered maximal force in climbing holds. The biomechanical analysis confirmed that the atypical "hook grip" was likely at the origin of the rupture, since flexor digitorum superficialis tendon force for this grip is greater than in other climbing grip techniques. The "hook grip" seems to be dangerous and should be used cautiously by climbers to prevent similar pathology. Additionally, the patient should henceforth be careful when climbing, since the biomechanical model showed that the remaining flexor digitorum profundus tendon was overused.
运动攀岩越来越受欢迎，手外科部门的攀岩者咨询量也在增加。与这项运动相关的疾病主要涉及滑轮系统，肌腱很少受到影响。我们报告了一例男性攀岩者在使用非典型攀岩握法（“钩握法”）时左手中指屈肌浅肌腱出现非典型撕裂的病例。这种握法包括掌指关节伸展和近端指间关节最大弯曲，仅在中指中节施加力。使用手指肌肉骨骼建模进行了生物力学分析，将钩握法与其他握法进行了比较，并评估了患者的恢复表现。适应性功能治疗结合物理治疗似乎是治疗这种非典型损伤的一个很好的选择，因为患者在日常生活中恢复了手指的正常使用。他在攀岩握把中恢复了最大力量。生物力学分析证实，非典型的“钩握法”很可能是撕裂的根源，因为这种握法的屈指浅肌肌腱力大于其他攀岩握法。“钩握法”似乎很危险，攀岩者应谨慎使用，以防止类似的病理。此外，由于生物力学模型显示剩余的屈指深肌腱过度使用，因此患者在今后攀岩时应小心。
