UKC

I just got back from seeing my orthopaedic specialist for finger pain. He gave me the option of a steroid shot or an operation. I opted for the injection for now, but if the pain recurs, I will need to consider the operation. My specialist says that the A1 pulley is as useful as the appendix and that it can be cut to remove the friction on the tendon which is the source of my inflammation. It sounds a bit drastic to me. Has anyone else had it done or know anyone who has? Interested in experiences and results.

That's not a conventional opinion on the A1 pulley! I've never heard of pulley removal, and surgical repair/reconstruction is normally a last resort for full 'bowstringing' multi-pulley ruptures, I'd strongly recommend a second opinion before you agree to surgery.

I know several people who have an untreated fully ruptured pulley leaving a permanently 'bowstringed' finger, it causes a lot of other issues for them including limited movement, problems jamming etc.

Volker Schoffel is the leading hand surgeon for climbers, read his book 'one move too many' if you want more depth on treatment options and well qualified advice.

I have a permanent bent index finger on my left hand, had it for about 10 years now. I pulled the tendon at the climbing wall, then went to work the next day and gripped the handles of a forklift all day, after that it couldn't be straightened. The GP gave me the option of an operation which had a risk of straightening it but never being able to bend the finger, or just put up with it as it is. I can do most things with it except hand jam but I was never any good at that anyway

Ive just had a year out of climbing with this injury. Hand surgeon i saw at Leeds general  stated 6 months off straight away if you want to try to avoid surgery...whole of the summer basically.

He was initially pleased with the the ongoing healing and gave me 50/50 chance of returning to climbing without it failing again. If i needed the Op he was going to take Flexor retinaculum from the palmer aspect wrist to use as a new/repair ligament. He suggested it would be strong but would leave a bulky left ring finger, in passing he mentioned he was seeing more and more pulley injuries mostly from indoors walls...were i snapped mine.

The good news...ive returned to climbing without needing the Op but it was very very slowly basically double the time to regain strength/density in all structures of the hand...small crimpy holds, i dont bother just not worth another year off for me.

id treat with great caution any suggestions parts of the body are not useful...medicine is strewn with that idea, the classic being the meniscus in the knee, used to whip them out claiming the same developmental relic....pro football America saw a surge in early onset Arthritic knees....they stopped removing the meniscus. We know know its a very important structure of the knee.

So far so good

Thanks for sharing your experience. You say yours snapped. Was it a pulley in the finger? A1 is in the palm, just below the knuckle. The problem I have is apparently that I have a nodule on the tendon that catches in the pulley which causes inflammation.

Yep A1 and A2 to be exact, both ruptured.

Ouch.

Or go to see him in Germany. He is very reasonably priced and well worth the investment....