Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

The pulley system, present on the flexor surface of each finger, has been described as consisting of five annular, four cruciate and one palmar aponeurosis pulley. The function of the pulley system is to prevent bowstringing of the tendons on finger flexion. Many studies have looked at which combination of pulleys are required for mechanically efficient finger flexion and their results have guided hand surgeons in pulley preservation and reconstruction. In this article we review the anatomy of the flexor pulley system and its clinical relevance.

Original publication




Journal article


The british journal of hand therapy


SAGE Publications

Publication Date





80 - 84