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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.
Trigger finger, also known as stenosing tenosynovitis, is a disorder characterized by catching or locking of the involved finger in full or near full flexion, typically with force. [2] There may be tenderness in the palm of the hand near the last skin crease (distal palmar crease ). [ 3 ]
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.
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 ...
Damage to the flexor tendon pulleys that encircle and support the tendons that cross the finger joints is the most common finger injury within the sport (see climber's finger). [4] The main culprit for pulley related injuries is the common crimp grip, especially in the closed position.
The flexor tendon sheaths are firmly attached to the proximal and middle phalanges by annular pulleys A2 and A4, while the A3 pulley and the proximal fibres of the C1 ligament attach the sheaths to the mobile volar ligament at the PIP joint.
Passing through the first tendon compartment together with the abductor pollicis longus, it is attached to the base of the proximal phalanx of the thumb. It extends the thumb and, because of its close relationship to the long abductor, also abducts the thumb. It is innervated by the deep branch of the radial nerve (C8-T1). [4]
The number and extent of these cruciate and annular ligaments varies among individuals, but three cruciate and four or five annular ligaments are normally found in each finger (usually referred to as, for example, "A1 pulley" and "C1 pulley"). The thumb has a similar system for its long flexor tendon but with a single oblique pulley replacing ...