Flexor tendon pulley injury in a bowler

Closed traumatic flexor injuries of the hand involving the pulley mechanism are a relatively common injury seen in rock climbers but are very rare in nonclimbers, including bowlers. The injury was first described in 1990. Since then, several studies have shed more light on the diagnostic and therapeutic considerations. Early diagnosis of pulley injuries is crucial since delayed diagnosis can lead to limited range of motion, particularly at the proximal interphalangeal joint. Flexion contractures at the proximal interphalangeal joint have also been cited in the literature. We discuss a case of pulley injury in a bowler and briefly review the anatomy of the pulley architecture, mechanism of injury, imaging manifestations, and clinical management of this injury.