The Effect of Circumferential Taping on Flexor Tendon Pulley Failure in Rock Climbers

The purpose of this study was to determine whether circumferential taping of the base of the finger increases the A2 pulley's load to failure in a model simulating a rock climber's grip. Nine pairs of fresh-frozen cadaveric hands, 20 to 47 years of age, were rigidly mounted in a specialized jig that maintained the finger in the climber's “crimp” position. Two of the four fingers of each hand were reinforced over the A2 pulley with three wraps of cloth adhesive tape. The flexor digitorum profundus and superficialis tendons were distracted until pulley or tendon failure. Overall, A2 pulley strength was greater in male specimens than in female specimens, and the A2 pulley of the small finger was the weakest tested. The A2 pulley failed simultaneously with the A3 and A4 pulleys in 55% of the tests. In the remaining trials, a single pulley failed initially followed by the remainder of the sheath. Of the 72 fingers studied, complete data were available for comparison of 22 pairs of fingers. No statistically significant difference in load to A2 pulley failure was noted between the taped and untaped finger pairs. Based on our findings we do not support taping the base of the fingers as a prophylactic measure against flexor tendon sheath injury in the climbing athlete.

[1]  W. H. Bowers,et al.  Closed traumatic rupture of finger flexor pulleys. , 1994, The Journal of hand surgery.

[2]  M. Gabl,et al.  [Isolated injuries of the pulley of the finger flexor tendon sheath--injuries in extreme climbing sports]. , 1992, Sportverletzung Sportschaden : Organ der Gesellschaft fur Orthopadisch-Traumatologische Sportmedizin.

[3]  Michael D. Rooks,et al.  Injury Patterns in Recreational Rock Climbers , 1995, The American journal of sports medicine.

[4]  K. Shelbourne,et al.  Effects of Finger and Wrist Taping on Grip Strength , 1997, The American journal of sports medicine.

[5]  J R Doyle,et al.  Anatomy and function of the palmar aponeurosis pulley. , 1990, The Journal of hand surgery.

[6]  G. Lundborg,et al.  The role of the synovial fluid and tendon sheath for flexor tendon nutrition. An experimental tracer study on diffusional pathways in dogs. , 1980, Scandinavian journal of plastic and reconstructive surgery.

[7]  S. R. BOLLEN Injury to the A2 Pulley in Rock Climbers , 1990 .

[8]  Michael C. Meyers,et al.  Rock Climbing Injuries , 1995, Sports medicine.

[9]  S R Bollen,et al.  Hand injuries in competition climbers. , 1990, British journal of sports medicine.

[10]  Ferdinand Frauscher,et al.  Finger Injuries in Extreme Rock Climbers , 1999, The American journal of sports medicine.

[11]  G. Lister Indications and techniques for repair of the flexor tendon sheath. , 1985, Hand Clinics.

[12]  John Long How to Rock Climb , 1989 .

[13]  S R Bollen Upper limb injuries in elite rock climbers. , 1990, Journal of the Royal College of Surgeons of Edinburgh.

[14]  K. An,et al.  Functional anatomy of the human digital flexor pulley system. , 1989, The Journal of hand surgery.

[15]  J P Wyatt,et al.  A prospective study of rock climbing injuries. , 1996, British journal of sports medicine.

[16]  O Oelz,et al.  [An analysis of overstrain injuries in rock climbing]. , 1993, Schweizerische Zeitschrift fur Sportmedizin.

[17]  W P Cooney,et al.  Mechanical Properties of Human Pulleys , 1990, Journal of hand surgery.

[18]  L. Lantieri,et al.  Diagnosis of digital pulley rupture by computed tomography. , 1996, The Journal of hand surgery.

[19]  L. Hurst,et al.  The second annular pulley: a histologic examination. , 1996, The Journal of hand surgery.

[20]  J R Doyle,et al.  Anatomy of the finger flexor tendon sheath and pulley system. , 1988, The Journal of hand surgery.

[21]  M. Maitland,et al.  Injuries associated with rock climbing. , 1992, The Journal of orthopaedic and sports physical therapy.

[22]  G. P. Hess,et al.  Prevention and Treatment of Overuse Tendon Injuries , 1989, Sports medicine.

[23]  A. T. Cole Fingertip injuries in rock climbers. , 1990, British journal of sports medicine.

[24]  P. Manske,et al.  Strength of Human Pulleys , 1977, The Hand.

[25]  L. S. Matthews,et al.  Viscoelastic properties of cat tendon: effects of time after death and preservation by freezing. , 1968, Journal of biomechanics.

[26]  S R Bollen,et al.  Soft tissue injury in extreme rock climbers. , 1988, British journal of sports medicine.

[27]  B Strauch,et al.  Digital flexor tendon sheath: an anatomic study. , 1985, The Journal of hand surgery.

[28]  Y. Tropet,et al.  Closed traumatic rupture of the ring finger flexor tendon pulley. , 1990, The Journal of hand surgery.

[29]  T D Noakes,et al.  Elbow, forearm, wrist, and hand injuries among sport rock climbers. , 1996, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine.

[30]  Tait S. Smith,et al.  Pathomechanics of Closed Rupture of the Flexor Tendon Pulleys in Rock Climbers* , 1998, The Journal of bone and joint surgery. American volume.

[31]  A. Amis,et al.  The interior of the flexor tendon sheath of the finger. The functional significance of its structure. , 1988, The Journal of bone and joint surgery. British volume.

[32]  A. Amis,et al.  The fibrous flexor sheaths of the fingers. , 1988, Journal of anatomy.

[33]  P. Manske,et al.  Effect of pulley excision on flexor tendon biomechanics , 1986, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[34]  K. Shea,et al.  Manual demands and consequences of rock climbing. , 1992, The Journal of hand surgery.

[35]  P Bannister,et al.  Upper limb injuries associated with rock climbing. , 1986, British journal of sports medicine.