Resection of the Flexor Digitorum Superficialis for Trigger Finger With Proximal Interphalangeal Joint Positional Contracture

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• 作者：Yann Favre ; MD ; ^{yannfavre@bluewin.ch} ; Louis Kinnen ; MD
• 关键词：Trigger finger ; flexor digitorum superficialis ; positional contracture ; resection
• 刊名：The Journal of Hand Surgery
• 出版年：2012
• 出版时间：November, 2012
• 年：2012
• 卷：37
• 期：11
• 页码：2269-2272
• 全文大小：1316 K

文摘

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Purpose

Open release of the A1 pulley is a widely known procedure for the treatment of trigger finger. A subset of patients presents with both trigger finger and a positional contracture of the proximal interphalangeal (PIP) joint. These patients usually have a long history of trigger finger or have already undergone a surgical release of the annular pulley. This study is a retrospective review of the outcomes of resection of the flexor digitorum superficialis (FDS) for patients whose trigger finger was associated with a positional contracture of the PIP joint.

Methods

Thirty-six patients (39 fingers) were treated by resection of the FDS after section of the A1 pulley. The mean age of the patients was 63 years (range, 45-90 y). Seven patients (19 % ) had previously undergone an open release of the A1 pulley and had developed a positional contracture of the PIP joint 2 to 5 months afterward. We performed a retrospective review with a mean follow-up of 30 months (range, 12-60 mo). No patient was lost to follow-up. The active range of motion was recorded at the PIP joint before and after surgery.

Results

The mean preoperative positional contracture of the PIP joint was 24¡ã (range, 15¡ã-30¡ã). The mean postoperative positional contracture of the PIP joint was 4¡ã (range, 0¡ã-10¡ã). The most commonly affected digit was the middle finger (26 fingers, 67 % ). In 28 fingers (72 % ), full extension was achieved following only the surgical procedure. The remaining 11 fingers (28 % ) had a postoperative residual positional contracture (range, 5¡ã-10¡ã). However, all fingers achieved a full range of motion after physical therapy and an injection of betamethasone. All of the resected tendons had histological damage.

Conclusions

This technique is a useful treatment for selected patients whose trigger finger is associated with a positional contracture.

Type of study/level of evidence

Therapeutic IV.