A2 Pulley Reconstruction after Revascularization for Crushing or Amputation Injury of the Hand

Chung,  Soon Il; Lee,  Dong Chul; Kim,  Jin Soo; Ki,  Sae Hwi; Roh,  Si Young; Yang,  Jae Won

Journal of the Korean Society for Surgery of the Hand 2010;15(2):65-70.
Published online June 1, 2010.

Soon Il Chung, Dong Chul Lee, Jin Soo Kim, Sae Hwi Ki, Si Young Roh, Jae Won Yang

Department of Plastic and Reconstructive Surgery, Kwangmyung Sung-Ae General Hospital, Kyungki-do, Korea. ophand@gmail.com

Abstract

Purpose
We report the results of A2 pulley reconstruction following revascularization for crushing or amputation injury of the hand. MATERIALS AND METHODS: The A2 pulley reconstruction was performed in 5 patients(5 digits) in whom the flexion of finger is restricted due to loss of the A2 pulley. All the patients underwent replantation or revascularization for the treatment of crushing or amputation injury of hand. Methods for reconstructing pulley were a tendon graft using palmaris longus(3 cases) and extensor retinaculum(2 cases). For assessments, the total active range of motion was measured.

Results
Total active range of motion increased by a mean of 39degrees(range, 15~100degrees) after pulley reconstruction. The mean improvement was 44%(range, 12~69%) of the maximum expected motion.

Conclusion
In patients who underwent replantation or revascularization, the A2 pulley reconstruction after multiple-stage of flexor tendon reconstruction is a way to improve the active range of motion when the finger flexes.