CLIMBER'S FINGER

Introduction: Climbers sometimes support their body with one finger hooked on a rocky ledge. This peculiar manoeuvre may cause a characteristic injury of the flexor tendon sheath, named "climber's finger".

Symptoms: (1) A sharp pain when grasping, and a sudden "snap" sound and snapping phenomenon in the concerned fingers and (2) a tender palpable mass proximal to the PIP joint.

Mechanism of occurrence: When a finger forms a hook, the highest stress point of the flexor tendon sheath is between the first cruciform pulley and the second annular pulley. When the full body weight is held mainly with the weak first cruciform pulley, it sometimes ruptures.

Therapy: Conservative therapy to prevent bowstringing was applied for eight cases. Six patients recovered after three months; the other two cases underwent operations.

Conclusion: If conservative therapy is found to be ineffective after three months, suturing of the tendon sheath should be indicated for climber's finger.