PT  - JOURNAL ARTICLE
AU  - Bhumit Desai
AU  - Gonzalo Sumarriva
AU  - Ross Dunbar
TI  - Closed Traumatic A2 Through A4 Pulley Rupture and Flexor Digitorum Superficialis Avulsion Treated With Reconstruction
AID  - 10.31486/toj.19.0109
DP  - 2021 Mar 20
TA  - Ochsner Journal
PG  - 99--103
VI  - 21
IP  - 1
4099  - http://www.ochsnerjournal.org/content/21/1/99.short
4100  - http://www.ochsnerjournal.org/content/21/1/99.full
SO  - Ochsner J2021 Mar 20; 21
AB  - Background: Multiple closed spontaneous pulley ruptures are rare injuries and require surgical reconstruction to prevent functional deficits. Pulley rupture combined with avulsion of the flexor digitorum superficialis (FDS) tendon is an even more uncommon occurrence.Case Report: We describe a closed traumatic annular 2 (A2) through annular 4 (A4) pulley rupture with avulsion of the FDS tendon. This uniquely associated pathology was treated with a complex surgical reconstruction that corrected flexion contracture and tendon bowstringing in the left long finger. The desired outcome was achieved through A2 and A4 pulley reconstruction using an autologous palmaris longus tendon graft with FDS tendon excision and proximal interphalangeal joint capsulotomy.Conclusion: Multiple pulley rupture is not commonly combined with FDS avulsion, and treatment of this injury requires careful surgical planning based on pulley biomechanics to maximize postoperative function.