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In human anatomy, the annular ligaments of the fingers, often referred to as A pulleys, are the annular part of the fibrous sheathes of the fingers.Four or five such annular pulleys, together with three cruciate pulleys, form a fibro-osseous tunnel on the palmar aspect of the hand through which passes the deep and superficial flexor tendons.
The tendon is finally inserted on the base of the distal phalanx of the thumb. [ 1 ] 6.7 to 9.7 centimetres (2.6 to 3.8 in) in length, the tendon passes through a long and superficial synovial sheath which, passing obliquely from the radial border of the forearm into the thumb, extends from the proximal border of the extensor retinaculum to the ...
It passes through the carpal tunnel in a separate tendon sheath, after which it lies between the heads of the flexor pollicis brevis. It finally attaches onto the base of the distal phalanx of the thumb. It is innervated by the anterior interosseus branch of the median nerve (C7-C8) [3] Three dorsal forearm muscles act on the thumb:
The ring finger and thumb are most commonly affected. [1] The problem is generally idiopathic (no known cause). People with diabetes might be relatively prone to trigger finger. [3] The pathophysiology is enlargement of the flexor tendon and the A1 pulley of the tendon sheath.
Hyperextension of the wrist can lead to fracture of Lister's tubercle, as pressure is increased from the extensor pollicis longus tendon. [6] An "island-shaped" fracture can also expose the tendon to a rough edge and lead to tendon rupture (usually long after the initial fracture).
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Flexor tenosynovitis is a common finding in the patients with Linburg–Comstock syndrome. Another hypothesis is that anatomical variations, which in this case is an additional tendon slip, may act as space-occupying lesions and potentially contribute to carpal tunnel syndrome. [5]
Climber's finger is one of the most common climbing injuries within the sport of rock climbing, accounting for about 30% of finger injuries seen in climbers. [1] It is an overuse injury that usually manifests in a swollen middle or ring finger due to a damaged flexor tendon pulley, normally the A2 or A4 pulley.