TechniquesWidening of Pulley by Interdigitating CutsPatil, Rahul MCh; Bhandari, Laxminarayan MCh Author Information Christine M Kleinert Institute of Hand and Microsurgery, Louisville, KY Conflicts of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding. Address correspondence and reprint requests to Laxminarayan Bhandari, MCh, Christine M Kleinert Institute of Hand and Microsurgery, Louisville, KY 40202. E-mail: [email protected]. Techniques in Hand & Upper Extremity Surgery: December 2021 - Volume 25 - Issue 4 - p 235-238 doi: 10.1097/BTH.0000000000000340 Buy SDC Metrics Abstract While biomechanically important, pulleys present multiple challenges to a zone 2 flexor tendon repair and rehabilitation. Retrieval of tendon through an intact pulley is cumbersome. Following repair, venting is often needed to accommodate the bulk at repair site. On occasion, step lengthening, or even complete division of pulley and reconstruction with tendon graft are necessary. Finally, accessing the tendon under the pulley during tenolysis is difficult. The primary issue in all such cases is the lack of space under the pulley. We describe a technique of expanding the pulley by interdigitating cuts. This technique greatly increases the diameter of the pulley which could be demonstrated in cadaver model and noted in clinical setting. This technique is easy to perform and maintains the integrity of the pulley without complete division. It would allow easy tendon retrieval, provide space for the repair and gliding, and improve exposure during tenolysis. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.