Reconstruction of the A2 pulley in climbers

Reconstruction of the A2 pulley is recommended in cases of symptomatic complete rupture with bowstringing, which causes a loss of strength and climbing performance. The procedure involves creating a new pulley using a tendon graft (usually taken from the wrist), which is wrapped around the flexor tendons to keep them in contact with the phalanx. Gradual rehabilitation is essential. A return to climbing is generally envisaged between 4 and 6 months, depending on healing and functional recovery.