Second annular pulley - MRI finger of hand - Axial PD FS - e-Anatomy
View the module

Second annular pulley

Ligamentum anulare secondum

Definition

Muhammad A. Javaid

The second annular pulley (A2) is a strong fibrous band that runs along the proximal phalanx of each finger. It stretches from the base to about the middle of the proximal phalanx and forms part of the fibrous flexor sheath that surrounds the flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) tendons.

The A2 pulley is the largest and most important of all the pulleys. It holds the flexor tendons close to the bone, prevents them from bowstringing during flexion, and allows smooth, efficient finger movement and grip strength.

Please click here for detailed description of the annular pulleys and the annular part of fibrous sheath of digit of hand.

References

  • Hauger, O., Chung, C.B., Lektrakul, N., Botte, M.J., Trudell, D., Boutin, R.D. and Resnick, D., 2000. Pulley system in the fingers: normal anatomy and simulated lesions in cadavers at MR imaging, CT, and US with and without contrast material distention of the tendon sheath. Radiology, 217(1), pp.201-212.

  • Bianchi, S., Martinoli, C., De Gautard, R. and Gaignot, C., 2007. Ultrasound of the digital flexor system: normal and pathological findings. Journal of Ultrasound, 10(2), pp.85-92.

  • Makkouk, A.H., Oetgen, M.E., Swigart, C.R. and Dodds, S.D., 2008. Trigger finger: etiology, evaluation, and treatment. Current reviews in musculoskeletal medicine, 1(2), pp.92-96.

  • Petchprapa CN, Vaswani D. MRI of the Fingers: An Update. AJR Am J Roentgenol. 2019 Sep;213(3):534-548. doi: 10.2214/AJR.19.21217. Epub 2019 Jul 3. PMID: 31268729.

  • Gupta P, Lenchik L, Wuertzer SD, Pacholke DA. High-resolution 3-T MRI of the fingers: review of anatomy and common tendon and ligament injuries. AJR Am J Roentgenol. 2015 Mar;204(3):W314-23. doi: 10.2214/AJR.14.12776. PMID: 25714317.

  • Clavero JA, Alomar X, Monill JM, Esplugas M, Golanó P, Mendoza M, Salvador A. MR imaging of ligament and tendon injuries of the fingers. Radiographics. 2002 Mar-Apr;22(2):237-56. doi: 10.1148/radiographics.22.2.g02mr11237. PMID: 11896215.

Gallery