Trigger Finger of a Distal A2 Pulley

Jin Woo Jin; Byoung Youl Kang; Dong Hee Kim

doi:10.12790/jkssh.2016.21.2.89

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Jin, Kang, and Kim: Trigger Finger of a Distal A2 Pulley

CASE REPORT

J Korean Soc Surg Hand 2016;21(2):89-92.

Published online: 11 June 2016

DOI: https://doi.org/10.12790/jkssh.2016.21.2.89

Trigger Finger of a Distal A2 Pulley

Jin Woo Jin, Byoung Youl Kang, Dong Hee Kim

Departments of Orthopedic Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea

Correspondence to: Dong Hee Kim, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, 158 Paryong-ro, Masanhoewon-gu, Changwon 51353, Korea, TEL: +82-55-290-6030, FAX: +82-55-290-6888, E-mail: dhkim1149@gmail.com

Received 24 February 201510 May 2015 Accepted 11 May 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Trigger finger commonly occurs in A1 pulley. However, there have been occasional reports of proximal or distal A2 pulley and A3 pulley at other sites. Especially, trigger finger that occurs in A2 pulley is usually due to thickening of flexor tendon. Flexor tendon plasty surgery or A2 pulley partial release are well known treatments of A2 pulley trigger finger. We conducted pulley lengthening of the A2 pulley to a 62-year-old man who has trigger finger occurring in distal portion of the A2 pulley, and we report about this with good results obtained.

Keywords: A2 pulley, Trigger finger, Pulley lengthening

REFERENCES

1. Ryzewicz M, Wolf JM. Trigger digits: principles, management, and complications. J Hand Surg Am. 2006; 31:13546.

2. Nagaoka M, Yamaguchi T, Nagao S. Triggering at the distal A2 pulley. J Hand Surg Eur Vol. 2007; 32:210–3.

3. Rayan GM. Distal stenosing tenosynovitis. J Hand Surg Am. 1990; 15:973–5.

4. Seradge H, Kleinert HE. Reduction flexor tenoplasty: treatment of stenosing flexor tenosynovitis distal to the first pulley. J Hand Surg Am. 1981; 6:543–4.

5. Mitsionis G, Bastidas JA, Grewal R, Pfaeffle HJ, Fischer KJ, Tomaino MM. Feasibility of partial A2 and A4 pulley excision: effect on finger flexor tendon biomechanics. J Hand Surg Am. 1999; 24:310–4.

6. Peterson WW, Manske PR, Bollinger BA, Lesker PA, McCarthy JA. Effect of pulley excision on flexor tendon biomechanics. J Orthop Res. 1986; 4:96–101.

7. Al-Qattan MM. Trigger fingers requiring simultaneous division of the A1 pulley and the proximal part of the A2 pulley. J Hand Surg Eur Vol. 2007; 32:521–3.

8. Hirata H, Fujisawa K, Sasaki H, Morita A, Matsumoto M. Congenital triggering of the index finger at the A2 pulley. J Hand Surg Br. 1996; 21:609–11.

9. Tanaka T, Amadio PC, Zhao C, Zobitz ME, An KN. The effect of partial A2 pulley excision on gliding resistance and pulley strength in vitro. J Hand Surg Am. 2004; 29:877–83.

Fig. 1.

Intraoperative photograph. Note the thickness of flexor digitorum profundus tendon (*) at distal portion of A2 pulley in tendon retracted distally after A2 pulley is released.

Fig. 2.

Z-plasty of A2 pulley. A2 pulley has been extended with the use of Z-plasty technique.

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