Flexor Tendon

Gliding Resistance and Triggering After Venting or A2 Pulley Enlargement: A Study of Intact and Repaired Flexor Tendons in a Cadaveric Model

Bunata RE, Simmons S, Roso M, et al (Univ of North Texas Health Science Ctr, Fort Worth; John Peter Smith Hosp (Tarrant County Hosp District), Fort Worth, TX) J Hand Surg 36A:1316-1322, 2011^§

Abstract

Purpose

This study compared the effect of 2 techniques of pulley management—venting and pulley enlargement (complete A2 incision with pulley repair and sheath closure using a retinacular graft)—on gliding resistance and on the incidence of triggering following zone 2 flexor tendon repairs in human cadaver specimens.

Methods

In vitro gliding resistance and the incidence of triggering were determined in 10 human cadaver specimens under 5 progressive conditions: (1) intact, (2) tendon repair (both tendons cut and repaired with the sheath intact), (3) condition 2 plus 50% venting of the distal A2 pulley, (4) condition 2 with venting extended to 66% of distal A2, and (5) condition 4 plus pulley enlargement. Triggering was determined in the same specimens by 2 computational algorithms that detected force changes in the load cells used to measure gliding resistance.

Results

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