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The Palmar Aponeurosis Pulley as a Cause of Trigger Finger. A Report of Two Cases*
PAMELA J. SHERMAN, M.D.†, NEW YORK CITY; LEWIS B. LANE, M.D.‡, MANHASSET, NEW YORK
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Investigation performed at The Hospital for Special Surgery, New York City, and North Shore University Hospital, Manhasset
J Bone Joint Surg Am, 1996 Nov 01;78(11):1753-4
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Extract

Five annular and three cruciate pulleys make up the retinacular structures of the digital flexor tendon sheath1. The transverse fibers of the palmar fascial aponeurosis, which are anchored on each side of the synovial sheath of the flexor tendons in the palm, have been identified as constituting an additional flexor tendon pulley2,3. To our knowledge, the palmar aponeurosis pulley has not been reported as a cause of trigger finger. We describe two patients in whom persistent triggering of the flexor tendons was found, after operative release of the first annular pulley, to be occurring at the palmar aponeurosis pulley.
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