Use of the A3 pulley as an interposition flap to cover periosteal defects

摘要

Dear Sir, Loss of periosteal continuity after periosteal fracture or removal of bony exostoses can result in an exposed bone surface, with potential involvement of adjacent structures via adhesions, including flexor and extensor tendons (Yamazaki et al., 2008). This can lead to reduced function and therefore needs to be minimised as far as possible. We propose a simple technique for attempting such a reduction, while incurring minimal donor morbidity. A 14-year-old female with hereditary multiple exostoses developed one on the volar aspect of the index finger. This was restricting tendon excursion and was electively excised back to reproduce a more normal bone contour.