Flexor Digitorum Superficialis Excision for Trigger Finger - A Systematic Literature Review

Area of Science:

• Orthopedic surgery
• Hand surgery
• Musculoskeletal disorders

Background:

• Trigger finger, particularly advanced or recurrent cases, often requires surgical intervention beyond simple A1 pulley release.
• Patients with diabetes, rheumatoid arthritis, or fixed deformities may have poorer outcomes with standard treatments.
• Evidence for the efficacy and safety of flexor digitorum superficialis (FDS) tendon slip resection is limited.

Approach:

• A systematic review adhering to PRISMA guidelines was conducted.
• Searched PubMed, Cochrane CENTRAL, and Ovid Medline databases up to February 2022 for relevant English-language studies.
• Included studies reporting original data on outcomes and complications of FDS slip resection for adult trigger finger.

Key Points:

• Seven retrospective studies involving 420 fingers in 290 patients were analyzed.
• Isolated ulnar slip FDS resection was the most common procedure.
• Significant reduction in proximal interphalangeal joint fixed flexion deformity (58%) and improved total active motion (228.7°) were observed.
• Recurrence rate was 4.7%, and complications occurred in 11.2% of cases, with no new deformities like ulnar drift or swan neck.

Conclusions:

• Flexor digitorum superficialis (FDS) resection is a safe and effective surgical option for long-standing or complex trigger finger cases.
• The technique demonstrates low recurrence rates and is suitable for diabetic or rheumatoid arthritis populations.
• Further prospective and comparative studies are recommended to solidify evidence for this therapeutic approach.