The influence of the crimp and slope grip position on the finger pulley system

In this study the influence of the grip position (crimp grip vs. slope grip position) on the pulley system of the finger was investigated. For this purpose 21 cadaver finger (11 hands, 10 donors) were fixed into an isokinetic loading device. Nine fingers were loaded in the slope grip position and 12 fingers in the crimp grip position. The forces in the flexor tendons and at the fingertip were recorded. A rupture of the A4 pulley occurred most often in the crimp grip position (50%) but did not occur in the slope grip position, in which alternative events were the most common (67%). The forces in the deep flexor tendon (FDP) (slope grip: 371 N, crimp grip: 348 N) and at the fingertip (slope grip: 105 N, crimp grip: 161 N) were not significantly different between the 2 finger positions, but the forces acting on the pulleys were higher in the crimp grip position (A2 pulley: 287 N, A4 pulley: 226 N) than in the slope grip position (A2 pulley: 121 N, A4 pulley: 103 N). The crimp grip position may be the main cause for A4 pulley ruptures but the slope grip position may be hazardous for other injuries as the forces recorded in the flexor tendons and at the fingertip were comparable at the occurrence of a terminal event.