Injuries to the Finger Flexor Pulley Systems
| Grade I | Grade II | Grade III | Grade IV | |
| Injury | Pully Strain | Complete rupture of A4 or partial rupture of A2 or A3 | Complete rupture A2 or A3 | Multiple ruptures as A2/A3, A2/A3/A4 or single rupture (A2 or A3) combined with lumbricalis muscles or ligamental trauma) |
| Therapy | Conservative | Conservative | Conservative | Surgical repair |
| Immobilization period after surgery | None | 10 days | 10-14 days | 14 days |
| Functional therapy | 2-4 weeks | 2-4 weeks | 4 weeks | 4 weeks |
| Pully protection | Tape | Tape | Thermoplastic or soft-cast ring | Thermoplastic or soft-cast ring |
| Begin easy sport-specific activities | After 4 weeks | After 4 weeks | After 6-8 weeks | 4 months |
| Begin full sport-specific activities | 6 weeks | 6-8 weeks | 3 months | 6 months |
| Duration of taping through climbing | 3 months | 3 months | 6 months | >12 months |
Injuries to the Finger Flexor Pulley System in Rock Climbers: Current Concepts. Schöffl, Volker Rainer et al. Journal of Hand Surgery , Volume 31 , Issue 4 , 647 – 654
