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Does Bowstringing Affect Hand Function in Patients Treated With A1 Pulley Release for Trigger Fingers?: Comparison
Kwang-Hee Park1, Won-Jeong Shin, Sung-Joon Kim
1From the Department of Orthopedic Surgery, College of Medicine, and Department of Kinesiology and Medical Science, Graduate School, Dankook University, Cheonan, Korea.
Annals of Plastic Surgery
|July 12, 2018
Summary
A1 pulley release for trigger digits can cause bowstringing, but this does not impact long-term hand function. Both open and percutaneous methods showed similar functional outcomes despite initial differences in bowstringing.
Area of Science:
- Orthopedics
- Hand Surgery
- Musculoskeletal Imaging
Background:
- Trigger digits are a common condition affecting hand function.
- A1 pulley release is a standard surgical treatment.
- Bowstringing is a potential complication after A1 pulley release.
Purpose of the Study:
- To evaluate bowstringing after percutaneous and open A1 pulley release for trigger digits.
- To determine the influence of bowstringing on hand function and clinical outcomes.
Main Methods:
- Randomized controlled trial involving 62 patients with resistant trigger digits.
- Ultrasonography quantified bowstringing preoperatively and at 12 and 24 weeks post-surgery.
- Assessed pain, hand function (DASH), pinch power, and grip strength.
Main Results:
- Bowstringing increased at 12 weeks, with higher values in the open release group (P=0.035).
- Bowstringing decreased by 24 weeks, with no significant group difference.
- Both surgical techniques led to significant improvements in clinical outcomes without significant differences between groups at final follow-up.
- No correlation was found between bowstringing and clinical outcomes.
Conclusions:
- A1 pulley release, via open or percutaneous methods, can cause transient bowstringing.
- The degree of bowstringing does not appear to affect the overall clinical hand function or outcomes in patients with trigger digits.
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