A2 pulley (5-10mm) contributes least to arc of motion of thumb; if A2 is intact, cutting A1 or oblique pulley will not result in bowstringing; Pulley Reconstruction: Goals preserve or reconstruct 3 or more pulleys; A2 is important; unclear if A4 reconstruction is absolutely necessary (can be sacrificed during acute flexor tendon surgery) Graft material extensor retinaculum synovialized pulley surface, provides 4.4/5. Jul 02, 2011 · We identified the PPC of the thumb as the most reliable anatomic landmark for the A1 pulley. The proximal edge of the A1 pulley is 0.1 cm proximal to PPC, while the distal edge is approximately 0.5 cm distal to this landmark.Cited by: 5.
A1 pulley is first annular pulley which arises from the palmar plate and proximal portion of the proximal phalanx. It is at the level of metacarpophalangeal joints and is approximately 8 mm in width. The proximal edge of the 1st annular pulley lies about 2 cm from the proximal finger crease and the distal edge of A1 pulley lies about 1 cm from the proximal finger crease.Author: Arun Pal Singh. the exact location of the incision depends on the location of the A1 pulley relative to the crease in the thumb with fixed flexion posture, the proximal edge of the A1 pulley is immediately distal to the location of the palpable nodule when the IP joint is maximally extended5/5.
Mar 27, 2014 · Hello. A patient had a Release of A1 pulley of the thumb. In the op note it indicates that a transverse incision was made across the flexion crease of the MCP joint of the thumb, carried down bluntly through the subcutaneous tissue down to the Ai pulley. Jul 23, 2013 · Trigger finger – chondroid metaplasia, usually of the A1 pulley, associated with stenosing tenosynovitis. Usually idiopathic, occurring in women in the 5 th and 6 th decades of life (F:M 6:1), most commonly thought to be due to a genetic predisposition.
The average length of the for the A1 pulley of the thumb. thumb A1 pulley measured 0.61±0.17 cm. Therefore, the A previous attempt to describe landmarks for the A1 distal edge of the A1 pulley is predicted to be located 0.51 cm pulley relied on dorsal structures such as the dorsum of . The pulley at the base of the finger is called the “A1 pulley.” This is the pulley that is most often involved in trigger finger. The tendon sheath attaches to the finger bones and keeps the flexor tendon in place as it moves. The A1 pulley is near the opening of the tendon sheath.
Annular ligaments of fingers. The first annular pulley (A1 pulley), near the head of the metacarpal bone, lies in the flexor groove in the deep transverse metacarpal ligament. In the thumb there are two annular pulleys and a single oblique pulley.From: Phalanx.