Injuries to the Finger Flexor Pulley Systems

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  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

Tendon pulley systems

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

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