Triggering secondary to an untreated partially-cut flexor tendon

Area of Science:

• Hand surgery
• Orthopedic surgery
• Musculoskeletal system biomechanics

Background:

• Triggering of the finger is a common condition affecting the flexor tendons.
• Previous research has focused on tenosynovitis and nodular thickening as causes.
• Mechanical causes, especially post-traumatic, require further elucidation.

Observation:

• A case of triggering was reported in a patient with a healed flexor digitorum superficialis tendon.
• The triggering was associated with a flap cut on the radial slip of the tendon.
• This occurred at the proximal border of the A2 pulley within an intact tendon sheath.

Findings:

• Surgical intervention involving shaving the flap successfully resolved the triggering.
• This demonstrates a specific mechanical etiology of triggering secondary to iatrogenic tendon injury.
• The intact tendon sheath played a role in the presentation.

Implications:

• This case expands the understanding of mechanical causes of triggering after flexor tendon surgery.
• It highlights the importance of meticulous surgical technique to avoid iatrogenic flap formation.
• Further investigation into similar mechanical triggers in flexor tendon injuries is warranted.