Surgical repair of flexor tendon pulley rupture in high level rock climbing

Background: Twelve high-level rock climbers were operated on for flexor tendon pulley rupture. Circumstances of pulley rupture and contributing factors are studied; postoperative improvement is evaluated by rock climber level increase, compared to the initial level.

Methods: Average age was 28 years and there were nine males and three females; all of them were high-level rock climbers, succeeding at least in 7a climbing ways before the accident. The surgical procedure was to replace the deficient pulley using an extensor retinaculum graft.

Results: The non-dominant hand was the most frequently involved, and especially A2 pulley of the fourth finger. Diagnosis was easy and clinically established.

Conclusions: Medical or functional treatments never allowed climbers to reach their former level. The only efficient treatment was surgical, whatever the time elapsed between injury and surgery. After this surgical procedure, five of the twelve patients improved their results, five recovered their former level and two decreased. The results are analysed and compared to other surgical procedures. Conclusions: Surgical repair of rupture of flexor tendon pulley during sport is the only efficient treatment allowing the rock climber to recover and improve its performance.