A1 Pulley Reconstruction for Severe Trigger Finger

Summary

Here, we present a protocol to compare A1 pulley reconstruction with traditional release surgery in treating a trigger finger, revealing enhanced outcomes and patient satisfaction through the Michigan Hand Outcomes Questionnaire.

Abstract

The aim of this study was to evaluate the effectiveness of A1 pulley reconstruction in treating severe trigger fingers and to compare its outcomes with those of the traditional A1 pulley release technique. A total of 43 patients participated in the study, divided into two groups: 22 patients underwent A1 pulley reconstruction, while the remaining 21 patients received the standard A1 pulley release procedure. The outcomes were assessed using the Michigan Hand Outcomes Questionnaire (MHQ) 1 month post-surgery. The results demonstrated that patients who received the A1 pulley reconstruction reported significantly better outcomes. These included enhanced hand function and quality of life, reduced levels of pain, improved aesthetic appearances, and higher overall satisfaction when compared to the traditional release group. The findings suggest that A1 pulley reconstruction offers superior benefits over the standard release procedure for individuals suffering from severe trigger fingers, highlighting its potential as a more effective surgical intervention.

Introduction

Trigger finger, medically known as stenosing tenosynovitis, is a condition that occurs when the flexor tendon sheath, which facilitates the smooth gliding of tendons within the finger, becomes inflamed and narrowed, and mostly a palpable nodule is present at the affected site^1,2. This constriction impedes the tendon's ability to move freely, leading to the characteristic catching or snapping sensation³. Distinguishing between association and causation is crucial. The majority of trigger digits are considered idiopathic, meaning that their cause is unknown. However, recent studies su....

Protocol

Written informed consent was obtained from the patients for publication. This surgical protocol adheres to the ethical standards established by the human research ethics committee of Zhejiang University School of Medicine.

1. Preoperative evaluation

1. Review the patient's medical history thoroughly, including the duration and severity of trigger finger symptoms.
2. Conduct a clinical examination, including finger mobility and the presence of nodules.
.......

Discussion

Severe trigger finger, characterized by persistent pain, locking, and impaired finger movement, often proves resistant to nonsurgical treatments. In such instances, surgical intervention becomes a necessary consideration¹. Percutaneous release procedures may be considered in some cases. This minimally invasive technique involves a needle being inserted into the tissue around the affected tendon, and a needle is used to break apart the constricting portion of the tendon sheath. Nakagawa et al. inve.......

Materials

Name	Company	Catalog Number	Comments
Blade #15	Hwato	20152020630
Electrosurgery unit	ECO	20152154637
Forceps	JZ	20140023
PDS*Plus Antibacterrial Polydioxanone violet Monofilament Suture 4-0	Johnson & Johnson	130705031047870	Surgical Suture Thread
Scalpel handle 7#	JZ	20161010
Scissors	JZ	20140012
Silk suture 4-0	WEGGO	20152020252	Surgical Suture Thread
Tourniquet	Zimmer	20162143149