Abstract: The flexor system of the fingers consisting of flexor tendons and finger pulleys are a key anatomic structure for the grasping function. Athletes and manual workers are particularly at risk for closed injuries of the flexor system: ruptured pulleys, ruptures of the flexor digitorum profundus from its distal attachment (‘‘jersey finger’’), and less frequently, ruptures of the flexor digitorum superficialis and of the lumbrical muscles. In the finger, the tendons pass through tunnels that keep them close to the bones, which helps them work better. Sonography is the best imaging modality associate with the clinical exam for it allows an experienced physician to make an accurate and early diagnosis, crucial to appropriate early treatment planning. The advances in suture techniques, better understanding of the tendon morphology and its biomechanics have resulted in better outcomes.
