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Delayed Annular Pulley Rupture Following Distal Radius Repair

Annular pulley injuries are commonly found in the 3rd and 4th fingers under extreme strain in rock climbers. Here is presented a case of pulley rupture in the 5th finger following surgery to the wrist with no specific injury to the finger itself. The mechanism of injury here is likely to be a combination of repetitive strain during rehabilitation, partial injury during initial fall, and possibly irritation to the tendon caused by surgical hardware. Diagnosis was inconclusive or not possible by other modalities (clinical and imaging) and ultrasound has proved useful here given the correct technique and a good knowledge of anatomy and pathology.