A mechanical study of six digital pulley reconstruction techniques: Part II. Strength of individual reconstructions.

A laboratory study was done on fresh-frozen human cadaver limbs, using six types of pulley reconstructions about the flexor tendons of the fingers. The reconstructions used were those described by (1) Bunnell, (2) Karev, (3) Weilby, and (4) Lister, and two types developed by us that have not been previously described. The pulleys were tested at constant strain rate to failure with the peak force recorded as the breaking strength. A total of 385 reconstructed pulleys were tested and the results were analyzed statistically. A new "loop and one half" pulley reconstruction was significantly stronger than the other five reconstructions (p less than 0.01) with an average load to failure of 22.5 kilograms-force. The other pulley reconstructions varied in average breaking strength from 2.8 kilograms-force to 18.4 kilograms-force.