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A2 Pulley Surgery

highaltitudeflatulentexpulsion · · Colorado · Joined Oct 2012 · Points: 35

At the time I was climbing strong and getting stronger. He didn't want to cause further damage. Basically it was the option of a strong and painful bent finger and a straight and possibly weak and painful finger.
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I think something internal that breaks down tissue (cortisone comes to mind) to get it to the point of flexibility then rebuild slowly with a focus on straightness. Trouble is, that finger would be much more prone to reinjury forever after that. At least now, with all the scar tissue, I can't really hurt it. And if I must mono, that's the one I use in hopes I might tear it off.

I have a friend who is a climber and accupuncturist who thought he could gradually break down the scar tissue with needles. I never tried it and he's moved out of the area, so I'm probably not going to try it with a full price accupuncturist.

robrobrobrob · · Unknown Hometown · Joined Oct 2012 · Points: 10

I love this thread. Almost 4 years ago I heard a pop, iced and didn't climb. Then went to a hand surgeon who suggested PT. Went through a lot of that, and got my finger far straighter.

Flash forward to this winter, and my ring finger starts curling in again. Went to a different hand specialist , and she suggested surgery. Actually 2 surgeries. Had the first one 2 weeks ago today, opened up the top to clear the joint and ensure extensor tendon was in the right place. Recovering from that now. I'm in for some weeks of serial casting and extension splints.

Once we regain some extension she will fix the 2 pulleys that are damaged. Unless. Oh how I fear that word right now. If we can't stretch the flexion tendon I will have to have fractional lengthening of that tendon, which will lead to some loss of strength.

Dr says the good news is that I have no arthritis in the PIP joint, small comfort when I am waiting for this flexion tendon to unbend my finger. Ugh. Not likely to have much time on the rock this summer!

Alecks · · Logan, UT · Joined Jun 2013 · Points: 5

So it has been a little over a year since surgery on my pulley rupture and I am happy to report complete success on the operation. I'm climbing all the time and climbing as hard as ever. I still tape, but I suspect that its more mental. I avoid overly crimpy routes, but when I have to crimp It feels strong and I have confidence in it. This should probably be the general approach to climbing. I'm also playing more guitar than ever, which was another concern of mine at the time. So Surgery worked. Shout out to my surgeon Dr. Bill Wagner at Seattle hand surgery group.

TJ Brumme · · Marrakech · Joined Dec 2011 · Points: 1,648
Alecks wrote:I am happy to report complete success on the operation. I'm climbing all the time and climbing as hard as ever.
Congrats on the successful surgery Alecks! What was your range-of-motion prior to surgery? My finger still has a permanent bend to it; thinking of skipping PT (trying to straighten with a splint) and going straight to surgery.
Alecks · · Logan, UT · Joined Jun 2013 · Points: 5

I would have had a permabend had I not had the operation. I completely ruptured the A2 and partially the A4. I would say that if you have a complete rupture consider surgery, but if its only partial consider PT. If its partial, it should heal on its own.

runout · · Unknown Hometown · Joined Jun 2013 · Points: 30

What kind of PT do you suggest?

Something similar happened to me recently. I felt a burning sensation in my knuckle. Thought I had scraped the wall as I fell or something but there was no external damage. No swelling. I went to the Doctor ASAP and after doing some tests suggested icing and IB. I can straighten my finger. I can make a fist but the finger feels weaker.

What's the recovery time like? Weeks? Months? Years? What should I do to get a speedy and full recovery?

Alecks · · Logan, UT · Joined Jun 2013 · Points: 5

Sounds like a different injury than what i had, So Im not sure what's up with your hand. I was back climbing within three months after surgery, which was incredible fast.

Alecks · · Logan, UT · Joined Jun 2013 · Points: 5

Update, almost 4 years later:

Over the years I have received many emails about my experiences with the pulley surgery, recovery, and getting back to climbing. I just want to report that almost 4 years after complete A2/A4 reconstruction I have not only returned to climbing but have made climbing and working in the climbing industry my life. I have become a dedicated route setter and have become a better climber than I ever thought possible even before my injury. I have seen and heard about  other climbers getting the surgery for the same or similar ruptures and are happy with the results and back climbing again. When I was injured there was little to no information regarding coming back to climbing after an operation like this and I felt like a guinea pig giving my finger over to the surgeon. It really couldn't have worked out better for me all things considered. 

Changes since the operation:

I have a giant scar that limits range of movement in the finger. This doesn't really affect climbing but I have to play guitar a little differently now.

I limit how much hard crimping I do, not just to protect that finger but to protect my hands in general

I worked hard to change how I climb, trying to maximize the weight on my feet and being as efficient as possible.

I boulder probably about a quarter as much as I used too, partly to protect my hands but also due to evolving preference

Hope this is helpful,

Alex

Guideline #1: Don't be a jerk.

Injuries and Accidents
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