Surgical Repair of Multiple Pulley Injuries—Evaluation of a New Combined Pulley Repair

PurposeWe report on a combined repair of multiple annular pulley tears using 1 continuous palmaris longus tendon graft to restore strength and function.MethodsWe treated 6 rock climbers with grade 4 pulley injuries (multiple pulley injuries) using the combined repair technique and re-evaluated them after a mean of 28 months.ResultsAll patients had excellent Buck-Gramcko scores; the functional outcome was good in 4, satisfactory in 1, and fair in 1. The sport-specific outcome was excellent in 5 and satisfactory in 1. Proximal interphalangeal joint flexion deficit slightly increased in 1 patient and remained the same in the other 5. Climbing level after the injury was the same as before in 4 and decreased slightly in 2 climbers.ConclusionsThe technique is effective with good results and has since become our standard treatment. Nevertheless, it is limited in patients with flexion contracture of the proximal interphalangeal joint.Type of study/level of evidenceTherapeutic III.