A 59-year-old woman, who previously underwent surgery on her left long finger A1 pulley and left small finger distal interphalangeal joint for triggering and mallet deformity at another medical facility in March 2021, sought evaluation at an Orthopedics Hand clinic. She presented with limited finger movement, a flexion contracture, and difficulty extending her left long finger. Examination revealed an A2 pulley injury with extensive scar tissue. Subsequently, she underwent surgery to remove the scar tissue and reconstruct the A2 pulley using suture tape anchors. This case highlights the negative outcome following A1 pulley release due to an unintended A2 injury, resulting in significant scarring and an intrinsic plus digit posture. Additionally, it underscores the potential effectiveness of using non-absorbable synthetic sutures to minimize scarring and promote an early range of motion in cases where healing leads to excessive scarring around the flexor tendon sheath.
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http://dx.doi.org/10.7759/cureus.61250 | DOI Listing |
Hand Surg Rehabil
January 2025
Chirurgie de la Main et de la Membre supérieur, Médipôle 1 rue Jules Méline, 51430 Bezannes, France.
Trigger finger, or stenosing tenovaginitis, is a common condition characterized by impaired flexor tendon sliding due to thickening of the A1 pulley. While open surgical release remains the gold standard for the treatment of persistent trigger finger, there is increasing interest in minimally invasive ultrasound-guided techniques to improve precision and outcomes. The purpose of this study is to evaluate the outcomes, safety, and complications associated with ultrasound-guided trigger finger release using a minimally invasive surgical knife.
View Article and Find Full Text PDFLateral epicondylitis, de Quervain tenosynovitis, and trigger finger are among the most common tendinopathies of the upper extremity. Lateral epicondylitis is a common condition that can be very frustrating to patients. Many patients will improve without any acute interventions.
View Article and Find Full Text PDFJt Dis Relat Surg
January 2025
Ankara Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, 06230 Altındağ, Ankara, Türkiye.
Objectives: This study aims to investigate the frequency of recurrence and prolonged postoperative symptoms in patients undergoing open A1 pulley release for trigger finger and to identify potential associated factors.
Patients And Methods: Between October 2021 and December 2023, a total of 72 patients (30 males, 42 females; mean age: 58.0±11.
J Physiol
December 2024
Delft University of Technology, Delft, The Netherlands.
A task as simple as holding a cup between your fingers generates complex motor commands to finely regulate the forces applied by muscles. These fine force adjustments ensure the stability and integrity of the object by preventing it from slipping out of grip during manipulation and by reacting to perturbations. To do so, our sensorimotor system constantly monitors tactile and proprioceptive information about the force object exerts on fingertips and the friction of the surfaces to determine the optimal grip force.
View Article and Find Full Text PDFBackground: There are various anatomical descriptions of the pulley system of the fingers and thumb. The A0 pulley, often referred to as palmar aponeurosis of the fingers, is of keen interest, especially regarding surgical release of the A1 pulley for trigger finger; however, there has been no anatomical description of the A0 pulley in the thumb.
Methods: Twenty-four cadaveric thumbs were dissected to expose the entire pulley system.
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