Trigger Fingers Requiring Simultaneous Division of the A1 Pulley and the Proximal Part of the A2 Pulley

2007 ◽  
Vol 32 (5) ◽  
pp. 521-523 ◽  
Author(s):  
M. M. AL-QATTAN
Keyword(s):  
Prospective Study ◽  
Range Of Motion ◽  
Full Range ◽  
Proximal Part ◽  
Adult Patients ◽  
Trigger Finger ◽  
A2 Pulley ◽  
A Prospective Study ◽  
A1 Pulley

In a prospective study of 50 adult patients with primary idiopathic trigger finger, four patients (8%) required simultaneous division of the proximal 3 to 4 mm of the A2 pulley as well as the A1 pulley in order to completely resolve the triggering. At final follow up at 6 to 12 months, all patients were symptom-free with a full range of motion of the fingers. This entity is discussed.

TREATMENT OF TRIGGER FINGERS BY INJECTION OF METHYLPREDNISOLONE ACETATE AND LIDOCAINE (DEPO-MEDROL®)

Hand Surgery ◽  
1996 ◽  
Vol 01 (02) ◽  
pp. 103-105
Author(s):  
J. Joris Hage ◽  
Jaap D.K. Munting
Keyword(s):  
Side Effects ◽  
Prospective Study ◽  
Success Rate ◽  
Adult Patients ◽  
Methylprednisolone Acetate ◽  
Short Term ◽  
Local Injections ◽  
One Year ◽  
A Prospective Study

Thirty-six adult patients with 44 trigger fingers of less than four months' duration entered a prospective study on the efficiency of treatment with local injections of a combination of corticosteroids and lidocaine. From this study it may be concluded that the short-term success rate (93%) of one to three injections of methylprednisolone and lidocaine 2% (Depo-Medrol®) is comparable to that achieved by surgical or percutaneous tenolysis. At one year of follow-up, this success rate still amounted to 86%. In our hands, this therapy is without complications or side effects.

A Prospective Study of Radiofrequency Rhizotomy in the Treatment of Posttraumatic Spasticity

Neurosurgery ◽  
1984 ◽  
Vol 15 (4) ◽  
pp. 526-529 ◽  
Author(s):  
David L. Kasdon ◽  
Ellen S. Lathi
Keyword(s):  
Spinal Cord ◽  
Prospective Study ◽  
Range Of Motion ◽  
Nursing Care ◽  
Posterior Root ◽  
Severe Spasticity ◽  
Rehabilitation Potential ◽  
A Prospective Study ◽  
Ablative Procedures

Abstract Posttraumatic spasticity severely impedes rehabilitation potential and nursing care. Treatment of severe spasticity has included medical therapy, spinal cord ablative procedures, anterior and posterior root lesions and peripheral denervations, and tendon releases. Open rhizotomy and percutaneous radiofrequency rhizotomy have achieved good results. We prospectively studied 25 patients with severe spasticity to assess the efficacy of percutaneous radiofrequency rhizotomy. All or most of the prospectively identified goals were accomplished in 24 of the 25 patients, with improvement persisting during an average follow-up period of 12 months. The improvement due to decreased tone was much greater than the improvement due to increased range of motion.

scholarly journals Comparative study of ultrasonography-guided percutaneous A1 pulley release versus blinded percutaneous A1 pulley release

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901877236 ◽  
Author(s):  
Sung Hyun Lee ◽  
Young Chae Choi ◽  
Hong Je Kang
Keyword(s):  
Patient Satisfaction ◽  
Postoperative Pain ◽  
Prospective Study ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Trigger Finger ◽  
Analog Scale ◽  
Vas Score ◽  
A1 Pulley

Purpose: The purpose of this study was to compare the results of blind versus ultrasonography-guided percutaneous A1 pulley release for treatment of trigger finger. Methods: This prospective study included 21 patients (25 fingers) who underwent blind release and 20 patients (23 fingers) who underwent ultrasonography-guided release. The visual analog scale (VAS) score, proximal interphalangeal joint contracture, complications, and patient satisfaction were compared between the groups. Results: At the final follow-up, triggering had disappeared in all patients who underwent ultrasonography-guided release, whereas three patients who underwent blind release required revision surgery for postoperative triggering. No complications were observed. VAS score was significantly different between groups at 2 and 4 weeks postoperatively. All patients who underwent ultrasonography-guided release were satisfied, whereas three patients who underwent blind release were not satisfied. Conclusion: Ultrasonography-guided percutaneous A1 pulley release for treatment of trigger finger reduces postoperative pain and complications, such as incomplete release, compared with a blind procedure.

scholarly journals Trigger Finger Release With Stepwise Preservation of the A1 Pulley: A Functional Pulley-Preserving Technique

2013 ◽  
Vol 98 (4) ◽  
pp. 437-444 ◽  
Author(s):  
Vachara Niumsawatt ◽  
David Mao ◽  
Stephen Salerno ◽  
Warren M. Rozen
Keyword(s):  
Hand Function ◽  
Metacarpophalangeal Joint ◽  
Trigger Finger ◽  
Joint Stability ◽  
Original Size ◽  
A Prospective Study ◽  
Reconstructive Techniques ◽  
A1 Pulley ◽  
Important Structure

Abstract The first annular (A1) pulley is an important structure of the hand, providing a biomechanical support to the metacarpophalangeal joint and maintaining joint stability and flexor tendon alignment. Albeit uncommon, disruption of this pulley can result in dislocation or ulnar drift of the digit, particularly pronounced in patients with rheumatoid arthritis. Despite this, the A1 pulley is commonly divided without reconstruction in trigger finger. Several annular pulley reconstructive techniques have been developed to preserve its function. However, development of recurrent triggering has been observed due to fibrosis, largely due to inadequate release of the pulley. We have developed a technique to increase the volume within the flexor sheath while preserving the A1 pulley by way of stepwise lengthening. This has enabled an increase in the diameter of the pulley to 4 times its original size. A prospective study was performed comprising 10 trigger finger releases with stepwise lengthening of the A1 pulley. In all patients, there were no complications, and good hand function was achieved with no recurrence of triggering at 6 weeks of follow-up. This technique can thus safely achieve trigger release without sacrifice of the function of the A1 pulley.

The thickness of the A2 pulley and the flexor tendon are related to the severity of trigger finger: results of a prospective study using high-resolution ultrasonography

2015 ◽  
Vol 41 (2) ◽  
pp. 204-211 ◽  
Author(s):  
S.-J. Kim ◽  
C.-H. Lee ◽  
W.-S. Choi ◽  
B.-G. Lee ◽  
J.-H. Kim ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Proximal Part ◽  
Cross Sectional Area ◽  
Trigger Finger ◽  
Sectional Area ◽  
Cross Sectional ◽  
A2 Pulley ◽  
The Cross ◽  
High Resolution Ultrasonography ◽  
A1 Pulley

We aimed to investigate the relationship between the pulley-tendon complexes and the severity of trigger finger. The thickness of the A1 and A2 pulleys, and the cross-sectional area of the flexor tendon under the pulleys, were prospectively assessed using 17 MHz high-resolution ultrasonography, in 20 patients with trigger finger (31 fingers). A control group comprised 15 asymptomatic fingers. The thickness of the A1 pulley and the proximal part of the A2 pulley, and the cross-sectional area of the flexor tendon under the A2 pulley, were significantly increased in the patient group. Clinical grade was significantly correlated with the thickness of the A1 pulley, the thickness of the proximal part of the A2 pulley, and the cross-sectional area of the flexor tendon under the proximal part of the A2 pulley. This study confirmed that the thickness of the A2 pulley and flexor tendon under the A2 pulley seems to be related to the severity of trigger finger. Level of evidences: Level III

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