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Updated: Apr 5, 2026
A Novel Application of Musculoskeletal Ultrasound Imaging
Published on: September 17, 2013
Sonographical parameters of the finger pulley system in healthy adults
Dominik Bassemir1, Frank Unglaub1,2, Peter Hahn1
1Department of Hand Surgery, Vulpius Klinik, Vulpiusstraße 29, 74906, Bad Rappenau, Germany.
Introduction:
To establish normative values of tendon to bone distances (TBDs) to evaluate the A2 and A4 annular pulley integrity, we hypothesized that these values correlate with gender, athletic exercise, occupation, individual's age and body height.
Methods:
Ultrasonography of 200 healthy individuals was performed prospectively. TBDs for the A2 and A4 pulley sections were measured for all fingers. Evaluation was performed in resting position and active forced flexion. Examination parameters included gender, age, body height, occupation, athletic exercise level, and hand dominance. Assessment of resting position and active forced flexion was done.
Results:
No clinically relevant differences of TBDs with respect to the aforementioned parameters were observed. But TBDs were significantly greater in active forced flexion than in resting position for all measured pulley sections. Intraobserver reliability was very satisfactory.
Conclusions:
Establishing normative values will help to detect injured pulleys more precisely and examination should be performed both in resting position and active forced flexion.
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