Strength Measurement and Clinical Outcome after Conservatively Treated Pulley Ruptures in Climbers

Abstract

Ruptures of the finger flexor pulleys are the most frequent injuries in rock climbers. While multiple pulley injuries demand a surgical reconstruction, single ruptures are mainly treated conservatively. Nevertheless the question of the clinical outcome or a persisting finger strength deficit after conservative therapy arises. 21 rock climbers (age: 34±9 years) with a grade 2–4 pulley injury were re-evaluated 3.46 (range: 0.25 – 18) years after injury. The clinical evaluation followed a standard questionnaire in combination with an ultrasound examination in extension and forced flexion. In order to determine the finger strengths the subjects hung with the respective finger in various postures on a ledge attached above a doorframe. while standing on a force platform, which measured the relative release. The 21 subjects had old (3.46 years, range: 0.25 –18) pulley injuries on 27 fingers (10 A2, 1 A3, 11 A4, 3 A2/3, 2 A3/4). The clinical outcome was excellent (Buck-Gramcko-Score) in all cases the subjects regained their climbing level within a year. There was no difference between the initial ultrasound examination and the follow-up during the study. For 17 finger pairs data for the relative strength of the injured and the respective healthy finger could be gathered. The finger strength was not significantly different for the injured and the healty finger in either the hanging or the crim** finger position.