Biomedical Research

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Defection of phalanx: a complication of Bunnell's pulley reconstruction

Objective: To report defection of phalanx under the reconstructed pulleys with Bunnell’s technique.

Methods: We followed up 26 reconstructed annular pulleys in 23 digits of 18 cases for 20 months and analysed the X-ray results of those phalanges. The function of pulley reconstruction was observed. The joint flexion and extension movement of the finger joint was recorded.

Results: All the reconstructed pulleys were healed. The efficacy was good. No bowstringing sign was found. The defections of phalanx were found in the areas of reconstructed pulleys in all cases. Narrowing of medullary cavities, osteophyte formation and thinning of cortex of phalanges were found in some cases with X-ray examination. The joint flexion and extension movement of the finger joint has improved.

Conclusion: Defection of phalanges will be found after Bunnell’s pulley reconstruction. It could be caused by pulley’s pressure which is converted from the traction load of the flexor tendon. Prognostic Studies, Level IV.

Author(s): Chao Lu, Guanglei Tian