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

Area of Science:

• Hand surgery
• Orthopedic surgery

Background:

• Idiopathic trigger finger is a common condition requiring surgical intervention.
• Open-surgery release of the A1 pulley is a standard treatment.
• Recurrence and complications can occur after A1 pulley release alone.

Purpose of the Study:

• To evaluate the efficacy of combined A1-A2 pulley release in reducing complications after trigger finger surgery.
• To determine the rate of recurrent triggering and permanent proximal interphalangeal joint flexion (PPIJF) after different surgical approaches.

Main Methods:

• Retrospective review of 1305 open-surgery cases for idiopathic trigger finger.
• Data collected from medical records and telephone interviews with a minimum 1-year follow-up.
• Analysis of complications, including recurrent triggering and PPIJF, based on surgical technique (A1 pulley alone vs. combined A1-A2 pulley release).

Main Results:

• 13% of cases required simultaneous A1-A2 pulley release for complete tendon gliding.
• No bowstring complications were recorded, attributed to surgical and bandaging techniques.
• Overall complication rate was 11.8%; recurrent triggering and PPIJF occurred exclusively in patients with A1 pulley release only.

Conclusions:

• Combined A1-A2 pulley release significantly reduces the risk of relapse triggering.
• This combined approach also minimizes the incidence of permanent proximal interphalangeal joint flexion (PPIJF).
• Combined A1-A2 pulley release is a superior surgical technique for idiopathic trigger finger.