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Flexor tendon injuries

The A2 and A4 pulleys are the most important and should be preserved if at all possible; they are broad and lie between joints, whereas the A1 and A3 are thinner and are found at joints.

• Perfusion-Blood supply to the tendons comes primarily from the vinculae (from the Latin ‘vincio’ to bind) that have segmental branches from the digital arteries. Vessels also enter the tendon at bony insertions. The vascularity is concentrated

Table 1 Position of the five annular pulleys.