Flap Irritation Phenomenon (FLIP): Etiology of Chronic Tenosynovitis After Finger Pulley Rupture
in Journal of Applied BiomechanicsClick name to view affiliation
Klinikum Bayreuth
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Klinikum Bamberg
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After a pulley rupture, most climbers regain the full function of their previously uninjured fingers. However, in some cases of pulley rupture, a persistent inflammation of the tendon sheath is observed. In this study, 16 cadaver fingers were loaded until pulley rupture and then studied for the rupturing mechanism. In addition, two patients with this pathology were investigated using ultrasound and MRI, and received surgery. In 13 fingers, a rupture of one or several pulleys occurred and almost always at the medial or lateral insertion. In one finger, a capsizing of the pulley underneath the intact tendon sheath was observed, leading to an avulsion between tendon and tendon sheath. A similar pathology was observed in the ultrasound imaging, in MRI, and during surgery in two patients with prolonged recovery after minor pulley rupture. In cases of prolonged tenosynovitis after minor pulley rupture, a capsizing of the pulley stump is probably the cause for constant friction leading to inflammation. In those cases, a surgical removal of the remaining pulley stump and sometimes a pulley repair may be necessary.
Isabelle Schöffl (Corresponding Author) is with the Institute for Anatomy I, Friedrich-Alexander-University Erlangen-Nuremberg, and with the Department for Paediatrics, Klinikum Bayreuth, Germany. Thomas Baier is with the Department for Diagnostic and Interventional Radiology, Klinikum Bamberg, Germany. Volker Schöffl is with the Department for Sport Orthopaedics, Klinikum Bamberg, and with the Department for Trauma Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Germany.
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