Trigger finger at the A2 pulley in children – two case reports

2010 ◽  
Vol 63 (8) ◽  
pp. e635-e636 ◽  
Author(s):  
Kazuo Ikeda ◽  
Naoki Osamura
Keyword(s):  
Case Reports ◽  
Trigger Finger ◽  
A2 Pulley

Trigger Finger in a Child as a Complication of Interphalangeal Dislocation

1998 ◽  
Vol 23 (4) ◽  
pp. 541-541 ◽  
Author(s):  
R. D. CASE ◽  
I. J. LESLIE
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Trigger Finger ◽  
A2 Pulley

We describe stenosis of the A2 pulley in a 13-month-old infant following a dislocation of a proximal interphalangeal joint, resulting in triggering of the finger.

Trigger Finger of a Distal A2 Pulley

2016 ◽  
Vol 21 (2) ◽  
pp. 89
Author(s):  
Jin Woo Jin ◽  
Byoung Youl Kang ◽  
Dong Hee Kim
Keyword(s):  
Trigger Finger ◽  
A2 Pulley

Disruption of Flexor Tendon after Intrasheath Triamcinolone Acetonide Injection for Trigger Digits: Two Case Reports

2017 ◽  
Vol 22 (03) ◽  
pp. 380-383 ◽  
Author(s):  
Toshikazu Tanaka ◽  
Takeshi Ogawa ◽  
Takaji Yanai ◽  
Eriko Okano ◽  
Sho Kohyama ◽  
...  
Keyword(s):  
Triamcinolone Acetonide ◽  
Flexor Tendon ◽  
Case Reports ◽  
Trigger Finger ◽  
Flexor Tendons ◽  
Lidocaine Solution ◽  
Female Nurse ◽  
Little Finger

We experienced two cases of flexor tendons rupture after triamcinolone acetate (TA) injection for trigger finger. A 45-year-old man underwent injection of 40 mg of TA and 1 mL of 1% lidocaine solution into his little finger. While playing golf 3 months after the injection, he heard a popping sound, and was unable to flex it. A 57-year-old female nurse had undergone injection of 40 mg of TA and 1 mL of 1% lidocaine solution into her thumb twice at a 2-month interval. Two months after the second injection, she was unable to flex it. Both cases had high concentrated TA injection at trigger digits. The present and previous cases illustrate that when TA is injected into trigger digits, the dose should be low, the safety interval should be long, and refuse injection into the tendon proper.

scholarly journals A Cadaveric Study of the Thread Trigger Finger Release: The First Annular Pulley Transection Through Thread Transecting Technique

Hand ◽  
2017 ◽  
Vol 13 (2) ◽  
pp. 170-175 ◽  
Author(s):  
Danqing Guo ◽  
Danzhu Guo ◽  
Joseph Guo ◽  
Logan C. McCool ◽  
Brionn Tonkin
Keyword(s):  
Clinical Study ◽  
Flexor Tendon ◽  
Carpal Tunnel Release ◽  
Cadaveric Study ◽  
Trigger Finger ◽  
Digital Nerve ◽  
Iatrogenic Injuries ◽  
A2 Pulley ◽  
Annular Pulley ◽  
A1 Pulley

Background: After the thread transecting technique was successfully applied for the thread carpal tunnel release, we researched using the same technique in the thread trigger finger release (TTFR). This study was designed to test the operational feasibility of the TTFR on cadavers and verify the limits of division on the first annular (A1) pulley to ensure a complete trigger finger release with minimal iatrogenic injuries. Methods: The procedure of TTFR was performed on 14 fingers and 4 thumbs of 4 unembalmed cadaveric hands. After the procedures, all fingers and thumbs were dissected and visually assessed. Results: All of the digits and thumbs demonstrated a complete A1 pulley release. There was no injury to the neurovascular bundle (radial digital nerve in case of thumb), flexor tendon, or A2 pulley for each case. Conclusions: The cadaveric study showed that the technique of TTFR was safe and effective, and the future clinical study is necessary to verify the findings of this study.

scholarly journals Closed Partial Flexor Digitorum Profundus Rupture: An Unusual Cause of Pediatric Trigger Finger

Hand ◽  
2016 ◽  
Vol 12 (5) ◽  
pp. NP92-NP94
Author(s):  
Shane R. Jackson ◽  
Meily Tan ◽  
Kim O. Taylor
Keyword(s):  
Tendon Injury ◽  
Trigger Finger ◽  
Flexor Digitorum Profundus ◽  
Flexor Tendon Injury ◽  
Normal Tendon ◽  
Operative Exploration ◽  
A2 Pulley ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon ◽  
Tendon Laceration

Background: Trigger finger is a common condition, causing impaired gliding of the digital flexor tendons. Chronic inflammation is the usual cause, but acute trigger finger following partial tendon laceration has also been described. Methods: We describe the case of a four year old girl who presented with inability to flex her index finger. Operative exploration revealed a closed partial rupture of the flexor digitorum profundus tendon, catching on the A2 pulley and preventing normal tendon gliding. Results: Excision of the damaged section of tendon allowed normal gliding motion, and once the wound had healed the patient regained full painless motion. Conclusion: Acute trigger finger caused by partial flexor tendon injury is an uncommon but well-documented presentation. Surgical exploration not only confirms the diagnosis, but allows for excision of the damaged segment to return normal movement without compromising strength.

scholarly journals A cadaveric assessment of percutaneous trigger finger release with 15° stab knife: its effectiveness and complications

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Abbas Abdoli ◽  
Majid Asadian ◽  
Seyed Houssein Saeed Banadaky ◽  
Rabeah Sarram
Keyword(s):  
Success Rate ◽  
Tendon Injury ◽  
Trigger Finger ◽  
Safe Alternative ◽  
Flexor Tendons ◽  
Flexor Tendon Injury ◽  
Percutaneous Release ◽  
Significant Difference ◽  
A2 Pulley ◽  
A1 Pulley

Abstract Percutaneous release of the A1 pulley has been introduced as a therapeutic approach for trigger fingers and is suggested as an effective and safe alternative, where conservative treatments fail. The aim of the current study was to determine if percutaneous release with a 15° stab knife can effectively result in acceptable efficacy and lower complication rate. Methods In the present study, the percutaneous release of the A1 pulley was evaluated by percutaneous release using a 15° stab knife in 20 fresh-frozen cadaver hands (10 cadavers). One hundred fingers were finally included in the present study. The success rate of A1 pulley release as well as the complications of this method including digital vascular injury, A2 pulley injury, and superficial flexor tendon injury was evaluated, and finally, the data were analyzed by the SPSS software. Results The results showed a success rate of 75% for A1 pulley release in four fingers, followed by eleven fingers (90%) and eighty-five fingers (100%). Therefore, the A1 pulley was found to be completely released in eighty-five fingers (100%). Overall, the mean of A1 pulley release for these fingers was determined as 97.9%, indicating that percutaneous trigger finger release can be an effective technique using a 15° stab knife. Furthermore, our findings revealed no significant difference in the amount of A1 pulley release in each of the fingers in the right and left hands. Additionally, 17 fingers developed superficial scrape in flexor tendons, while 83 fingers showed no flexor tendons injuries and no other injuries (i.e., vascular, digital nerve, and A2 pulley injuries). Conclusions Percutaneous release of the A1 pulley using a 15° stab knife was contributed to acceptable efficacy and a relatively good safety in the cadaveric model.

Open Surgery for Trigger Finger Required Combined a1-a2 Pulley Release. A Retrospective Study on 1305 Case

2019 ◽  
Vol 23 (3) ◽  
pp. 115-121 ◽  
Author(s):  
Vanni Strigelli ◽  
Luigi Mingarelli ◽  
Giulio Fioravanti ◽  
Gianfranco Merendi ◽  
Antonio Merolli ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Open Surgery ◽  
Trigger Finger ◽  
A2 Pulley

scholarly journals Location and Extent of A1, A2 Release and Its Impact on Tendon Subluxation and Bowstringing—A Cadaveric Study

2019 ◽  
Vol 52 (03) ◽  
pp. 349-354
Author(s):  
Laxminarayan Bhandari ◽  
Alireza Hamidian Jahromi ◽  
Aden Gunnar Miller ◽  
Huey Tien
Keyword(s):  
Surgical Treatment ◽  
Upper Extremity ◽  
Traction Force ◽  
Cadaveric Study ◽  
Trigger Finger ◽  
Flexor Tendons ◽  
Safe Limit ◽  
A2 Pulley ◽  
A1 Pulley

AbstractSurgical treatment of trigger finger involves release of A1 pulley. Some authors have theorized that the loss of A1 pulley can lead to ulnar subluxation of flexor tendons, which can be prevented by release of A1 pulley radially, even in a nonrheumatoid hand. However, there is no evidence in literature to either support or oppose this hypothesis. Occasionally, difficulty is encountered to precisely identify where A1 ends and A2 begins. While incomplete release of A1 can cause relapse of triggering, release of substantial A2 can cause bowstringing. Knowledge of the safe limit of concomitant A2 release is beneficial. The study was conducted in 12 cadaver upper extremity specimens. A1 pulleys of 48 fingers were divided at the radial (24 fingers) or ulnar (24 fingers) attachment. A 20lb traction force was applied on the flexor tendons. Any subluxation or bowstringing was noted. The experiment was repeated following serial release of the A2—initially 25%, followed by 50% and 100%. No bowstringing or subluxation was noted when A1 pulley was opened, either by radial or ulnar incision. The same was true for A1 + 25% A2 release. When A1 + 50% A2 pulley were released, bowstringing was observed in 3/48 fingers. When A1 + 100% of the A2 pulley were released, bowstringing occurred in all cases. The location of incision for release of the A1 pulley has no effect on bowstringing or tendon subluxation. Release of additional 25% of the A2 pulley can be performed safely, which corresponds to the level of palmar digital crease.

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