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This review explores the novel perspective that the intermediate tendon of the digastric muscle may function as an anatomical trochlear pulley system within the human body, challenging the traditional understanding of trochlear systems. While widely recognized trochlear units include structures like the medial part of the humerus and the superior oblique muscle of the orbit, the review focuses on the unique anatomical arrangement of the intermediate tendon of the digastric muscle in connection with the anterior and posterior bellies of the digastric muscles. Despite current debates within the anatomical community about labeling the digastric muscles as having a trochlea, this paper delves into the scientific definition of a trochlear pulley system, presenting the intermediate tendon of the digastric muscle as a potential trochlea.

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From the Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo, Tokyo (Dr. Kono, Dr. Taketomi, Dr. Kage, Dr. Inui, and Dr. Tanaka); the Department of Information Systems, Faculty of Engineering, Saitama Institute of Technology, Fukaya, Saitama (Dr. Yamazaki); the Department of Orthopedic Biomaterial Science, Osaka University Graduate School of Medicine, Suita, Osaka (Dr. Tamaki, and Dr. Tomita); the Department of Orthopedic Surgery, Saitama Medical University, Saitama Medical Center, Kawagoe, Saitama (Dr. Inui); and the Department of Health Science, Graduate School of Health Science, Morinomiya University of Medical Sciences, Suminoe, Osaka, Japan (Dr. Tomita).

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