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Research Article| Volume 13, ISSUE 4, P567-570, July 1988

Bowstringing as a complication of trigger finger release

  • Steven J. Heithoff
    Correspondence
    Reprint requests: Steven J. Heithoff, DO, 1037 Water St., Port Huron, MI 48061.
    Affiliations
    From the Townley Orthopedic Clinic, Port Huron, Mich., USA

    The Department of Orthopedic Surgery, Tufts University School of Medicine, the Hand Surgery Service, New England Baptist Hospital, and the Department of Occupational Therapy, New England Baptist Hospital, Boston, Mass., USA
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  • Lewis H. Millender
    Affiliations
    From the Townley Orthopedic Clinic, Port Huron, Mich., USA

    The Department of Orthopedic Surgery, Tufts University School of Medicine, the Hand Surgery Service, New England Baptist Hospital, and the Department of Occupational Therapy, New England Baptist Hospital, Boston, Mass., USA
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  • Judith Helman
    Affiliations
    From the Townley Orthopedic Clinic, Port Huron, Mich., USA

    The Department of Orthopedic Surgery, Tufts University School of Medicine, the Hand Surgery Service, New England Baptist Hospital, and the Department of Occupational Therapy, New England Baptist Hospital, Boston, Mass., USA
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.
      Bowstringing is a rare complication of trigger finger release caused by excessive loss of the proximal pulleys. As the flexor tendon moves away from the center of rotation of the metacarpophalangeal joint, the flexion moment arm is increased. Thus the flexors gain an increased mechanical advantage over the extensors resulting in limited digital extension. We describe a case of severe bowstringing progressing over 9 years resulting in pain, altered digital function, and loss of full extension.
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      References

        • Boyes JH
        Bunnel's surgery of the hand.
        5th ed. JB Lippincott, Philadelphia1970
        • Conklin JE
        • White WL
        Stenosing tenosynovitis and its possible relation to the carpal tunnel syndrome.
        Surg Clin North Am. 1960; 40: 531-540
        • Fahey JJ
        • Bollinger JA
        Trigger-finger in adults and children.
        J Bone Joint Surg. 1954; 36A: 1200-1218
        • Froimson AJ
        Green D Operative hand surgery. Churchill Livingstone, New York1982: 1510-1513
        • Flynn JE
        Hand surgery.
        3rd ed. Williams & Wilkins, Baltimore1981
        • Hueston JT
        • Wilson WF
        The etiology of trigger finger. Explained on the basis of intratendinous architecture.
        Hand. 1972; 4: 257-260
        • Kolind-Sorensen V
        Treatment of trigger fingers.
        Acta Orthop Scand. 1970; 41: 428-432
        • Lapidus PW
        Stenosing tenovaginitis.
        Surg Clin North Am. 1953; 33: 1317-1347
        • Lipscomb PR
        Tenosynovitis of the hand and the wrist: carpal tunnel syndrome deQuervain's disease trigger digit.
        Clin Orthop. 1959; 13: 164-181
        • Lamb DW
        • Kuczynski K
        The practice of hand surgery.
        CV Mosby, St. Louis1981
        • Milford L
        • Milford L
        The hand.
        2nd ed. The CV Mosby Co., St. Louis1982
        • Seradge H
        • Kleinert HE
        Reduction flexor tenoplasty. Treatment of stenosing flexor tenosynovitis distal to the first pulley.
        J Hand Surg. 1981; 6: 543-544
        • Lorthioir J
        Surgical treatment of trigger-finger by a subcutaneous method.
        J Bone Joint Surg. 1958; 40A: 743-795
        • Doyle JR
        • Blythe W
        The finger flexor tendon sheath and pulleys: anatomy and reconstruction.
        in: Symposium on tendon surgery in the hand, AAOS. The CV Mosby Co., St. Louis1975: 81-87
        • Lister GD
        Reconstruction of pulleys employing extensor retinaculum.
        J Hand Surg. 1979; 4: 461-464
      1. (30–60)
        • Brand PW
        Clinical mechanics of the hand.
        The CV Mosby Co., St. Louis1985
        • Brand PW
        • Ellis JC
        Tendon and pulleys at the metacarpophalangeal joint of a finger.
        J Bone Joint Surg. 1975; 57A: 779-784