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Case of the Month

March 2007

Symptoms

42 year-old with recent long finger injury and resultant deformity.

Diagnosis

Disruption of the A2 (white arrow), A3(black arrow), and A4 (black arrowhead) pulleys. The primary function of the pulley system is to provide stability to the flexor tendons during flexion by fixing them to the underlying osseous structures. Injuries to the pulley system, commonly seen in rock climbers, lead to bowstringing of the flexor tendons with abnormal separation from the underlying phalanges.

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