Grip Force Measurement as a Complement to High-Resolution Ultrasound in the Diagnosis and Follow-Up of A2 and A4 Finger Pulley Injuries.

Xeber Iruretagoiena-Urbieta,Javier De La Fuente-Ortiz De Zarate,Andoni Ormazabal-Aristegi,Marc Blasi,Felix Obradó-Carriedo,Elena Sonsoles Rodríguez-López

doi:10.3390/diagnostics10040206

Abstract

The ability of finger flexors to generate force has been studied in relation to climbing performance. However, not much attention has been paid to the decrease in finger grip force in relation to annular pulley injuries. The purpose of the present study was to determine if an injured annular pulley implies a finger flexor force decrease, as well as its relation to clinical and sonographic changes. We performed an observational study in 39 rock climbers with A2 or A4 pulley injuries to the 3rd or 4th fingers. The variables considered were pain upon palpation, ultrasound tendon–bone distance, and finger grip strength decrease. Three rock climbing grip types were considered: the one finger crimp, open crimp, and close crimp. Injured rock climbers presented a decrease in finger grip strength compared to non-injured controls when performing a one finger crimp (p < 0.001). There exists a significant correlation between a tendon–bone distance at the level of the injured pulley and a decreased finger grip strength measured by performing a one finger crimp (p = 0.006). A decrease in finger grip strength could be considered in the diagnostic and follow-up process of A2 and A4 pulley injuries to the 3rd and 4th fingers.

Highlights

IntroductionAlong with finger flexor tendon injuries, are the most frequent injuries experienced by rock climbers, accounting for up to 33% of all injuries in this population [1].The most frequently injured pulley is the A2, followed by the A4, mainly affecting the 4th finger.Ruptures may be partial or complete and isolated or multiple, the latter being clinically evidenced by the bowstringing of the flexor digitorum superficialis and/or profundus tendons [2,3].The different types of pulley ruptures may be clinically difficult to differentiate as the clinical presentation is unspecific, unless they present with the bowstringing of the flexor tendons [4].Symptomatology consists of acute focal pain, which increases upon palpation, and counter-resisted finger flexor maneuvers, occasionally accompanied by inflammatory signs and ecchymosis [5].Diagnostics 2020, 10, 206; doi:10.3390/diagnostics10040206 www.mdpi.com/journal/diagnostics
The different types of pulley ruptures may be clinically difficult to differentiate as the clinical presentation is unspecific, unless they present with the bowstringing of the flexor tendons [4]
The main aim of the present study was to determine if an isolated A2 or A4 pulley injury could in turn decrease finger grip strength

Summary

Introduction

Along with finger flexor tendon injuries, are the most frequent injuries experienced by rock climbers, accounting for up to 33% of all injuries in this population [1].The most frequently injured pulley is the A2, followed by the A4, mainly affecting the 4th finger.Ruptures may be partial or complete and isolated or multiple, the latter being clinically evidenced by the bowstringing of the flexor digitorum superficialis and/or profundus tendons [2,3].The different types of pulley ruptures may be clinically difficult to differentiate as the clinical presentation is unspecific, unless they present with the bowstringing of the flexor tendons [4].Symptomatology consists of acute focal pain, which increases upon palpation, and counter-resisted finger flexor maneuvers, occasionally accompanied by inflammatory signs and ecchymosis [5].Diagnostics 2020, 10, 206; doi:10.3390/diagnostics10040206 www.mdpi.com/journal/diagnostics. Along with finger flexor tendon injuries, are the most frequent injuries experienced by rock climbers, accounting for up to 33% of all injuries in this population [1]. Ruptures may be partial or complete and isolated or multiple, the latter being clinically evidenced by the bowstringing of the flexor digitorum superficialis and/or profundus tendons [2,3]. The different types of pulley ruptures may be clinically difficult to differentiate as the clinical presentation is unspecific, unless they present with the bowstringing of the flexor tendons [4]. Symptomatology consists of acute focal pain, which increases upon palpation, and counter-resisted finger flexor maneuvers, occasionally accompanied by inflammatory signs and ecchymosis [5].

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Conclusion