Purpose
The purpose of this study was to compare the clinical outcomes of A1 pulley release
with ulnar superficialis slip resection (group A) and simple A1 pulley release (group
B) in trigger finger with flexion contracture of the proximal interphalangeal (PIP)
joint.
Methods
From January 2016 to December 2019, the 2 surgical procedures were performed alternately
every year for trigger fingers with preoperative PIP joint flexion contractures of
≥10°. Twenty-six fingers in group A and 29 fingers in group B that were followed up
for >1 year were reviewed in this retrospective study. The visual analog scale (VAS)
score; Disabilities of the Arm, Shoulder, and Hand (DASH) score; degree of PIP joint
flexion contracture; grip strength; and pinch strength were measured after surgery
and compared.
Results
The differences in postoperative PIP joint flexion contracture between groups were
<4° at 2 and 6 weeks, and there were no clinically relevant differences at 6 weeks
and 12 months. At the final follow-up, PIP joint flexion contractures of 5° were observed
in 2 fingers in each group. The difference in VAS scores between groups was less than
half of a point until 3 months, and there were no clinically relevant differences
at 6 weeks and 12 months. The DASH score did not show any difference between groups
at the final follow-up. There were clinically relevant differences in the grip and
pinch strengths between groups at 6 weeks. However, there were no clinically relevant
differences at the final follow-up.
Conclusions
Proximal interphalangeal joint flexion contracture measurements and clinical scores
did not differ between groups at the final follow-up. Therefore, we recommend use
of a simple A1 pulley release, which is simpler than an A1 pulley release with ulnar
superficialis slip resection, in cases of trigger finger with PIP joint flexion contracture.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Published online: July 07, 2022
Accepted:
April 8,
2022
Received:
August 24,
2021
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
