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Updated: Jul 11, 2026
A Standardized Acupotomy Protocol For The Treatment of Tenosynovitis of Hand Flexor Tendons In Human Patients
Published on: May 26, 2026
Surgical treatment of the pediatric trigger finger
Donald S Bae1, Samir Sodha, Peter M Waters
1Crystal Run Healthcare, Rock Hill, NY, USA.
Insights
A standardized surgical technique effectively treats pediatric trigger fingers, with 91% of cases showing successful resolution after A1 pulley release and flexor digitorum superficialis (FDS) tendon slip resection.
Area of Science:
- Pediatric Orthopedics
- Hand Surgery
- Musculoskeletal Disorders
Background:
- Trigger finger, or stenosing tenosynovitis, is a common condition in children.
- Conservative management is often attempted, but surgical intervention may be necessary for persistent symptoms.
Purpose of the Study:
- To evaluate the efficacy and safety of a specific surgical technique for treating symptomatic pediatric trigger fingers.
- To assess the outcomes of A1 pulley release combined with flexor digitorum superficialis (FDS) tendon slip resection.
Main Methods:
- Retrospective review of 18 pediatric patients (23 trigger fingers) treated between 1996 and 2006.
- Surgical intervention involved A1 pulley release and resection of a single FDS tendon slip.
- Average follow-up was 43 months.
Main Results:
- Successful resolution of triggering occurred in 91% (21/23) of cases.
- Specific tendon pathologies were identified in 9 cases, including thickening and calcific tendonitis.
- Recurrence was rare and successfully managed with revision surgery; no major complications were noted.
Conclusions:
- Surgical release of the A1 pulley and resection of a single FDS tendon slip is a safe and effective treatment for pediatric trigger finger.
- This standardized technique offers predictable outcomes and high patient satisfaction.
Purpose:
The purpose of this investigation is to assess the efficacy of a standardized surgical technique in the treatment of symptomatic trigger fingers in pediatric patients.
Methods:
A retrospective study was performed of 18 consecutive patients with 23 trigger fingers treated at our institution between 1996 and 2006. Average age at the time of presentation was 4.5 years (range, 1-12 years). Involved digits included 2 index, 12 long, 3 ring, and 6 small fingers. All patients had surgical treatment consisting of A1 pulley release and resection of a single slip of the flexor digitorum superficialis (FDS) tendon. Average clinical follow-up evaluation was 43 months (range, 3-111 months).
Results:
In almost half of the cases, triggering was noted to occur at the level of the FDS tendon decussation. In 9 cases, specific tendon pathology was observed, including fusiform thickening, nodular thickening, calcific tendonitis, and cyst formation. Overall, 21 of 23 (91%) fingers demonstrated successful resolution of triggering without recurrence after surgical treatment. One patient had recurrent triggering, which was successfully treated by a second procedure to resect the remaining FDS slip. Another patient was successfully treated with excision of an aberrant muscle belly from the FDS. Both of these patients remained asymptomatic after their revision procedures. No other complications were observed. All patients returned to full activities, and 17 of 18 (94%) patients were satisfied with the results of surgery at most recent follow-up evaluation.
Conclusions:
The pediatric trigger finger may be safely and predictably treated by surgical release of the A1 pulley and resection of a single FDS tendon slip.
