Flexor tendon A2 pulley rupture after trigger finger surgery: Case report and literature review
DOI:
https://doi.org/10.1016/j.rccot.2015.04.004Keywords:
trigger finger, disorder/complications, tendons/surgery, fingers/surgery, biomechanical phenomena, case reportsAbstract
A 2 and A 4 pulleys are the most important biomechanical structures for the fingers flexor apparatus. A 2 pulley injuries originate clinical and functional distress not only to the finger itself but also to the hand as a whole. Hereby, we present a case report of two previously trigger finger patients who underwent to a release surgery and presented bowstring complications after the surgery, as well as a literature review on diagnosis and treatment of this kind of complication.
Evidence level: IV
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Wolfe SW, Hotchkiss RN, Pederson WC, Kozin SH. Green's operative hand surgery. 6.a ed. Philadelphia: Churchill Livingstone; 2010.
Schöffl VR, Jüngert J. Closed flexor pulley injuries in nonclimbing activities. J Hand Surg. 2006;31A:806-10. https://doi.org/10.1016/j.jhsa.2006.02.006
Doyle BW, Blythe W. The finger flexor tendon sheath and pulleys. Anatomy and reconstruction. En: Hunter JM, Scheider LH, editores. Symposium on tendon surgery in the hand. St Louis: Mosby; 1975. p. 81-7.
Idler RS, Strickland JW. The effects of pulley resection on the biomechanics of the PIP joint. J Hand Surg. 1984, 9A:595.
Lin GT, Amadio PC, An KN, Cooney WP. Functional anatomy of the human digital flexor pulley system. J Hand Surg. 1989;14A:949-56. https://doi.org/10.1016/S0363-5023(89)80043-7
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. https://doi.org/10.1002/jor.1100040112
Goldstein SA, Greene TL, Ward WS, Matthews LS. A biomechanical evaluation of the function of the digital pulleys. Orthop Trans. 1984;8:354.
Brand PW. Clinical mechanics of the hand. St. Louis: CV Mosby; 1985. p. 30-60.
Brand PW, Ellis JC. Tendon and pulleys at the metacarpophalangeal joint of a finger. J Bone Joint Surg. 1975;57A:779-84. https://doi.org/10.2106/00004623-197557060-00008
Bowers WH, Kuzma GR, Bynum DK. Closed traumatic rupture of finger flexor pulleys. J Hand Surg. 1994;19A:782-7. https://doi.org/10.1016/0363-5023(94)90183-X
Manske PR, Lesker PA. Palmar aponeurosis pulley. J Hand Surg. 1983;8:259-63. https://doi.org/10.1016/S0363-5023(83)80154-3
Lin GT, Amadio PC, An KN, Cooney WP, Chao EY. Biomechanical analysis of finger flexor pulley reconstruction. J Hand Surg. 1989;14B:278-82. https://doi.org/10.1016/0266-7681_89_90081-8
Tang JB. The double sheath system and tendon gliding in zone 2 C. J Hand Surg. 1995;20B:281-5. https://doi.org/10.1016/S0266-7681(05)80078-6
Tomaino M, Mitsionis G, Basitidas J, Grewal R, Pfaeffle J. The effect of partial excision of the A2 and A4 pulleys on the biomechanics of finger flexion. J Hand Surg Br. 1998;23B(1): 50-2. https://doi.org/10.1016/S0266-7681(98)80218-0
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. 1999;24A:310-4. https://doi.org/10.1053/jhsu.1999.0310
Moriya T, Thoreson AR, Zhao C, An KN, Amadio PC. The effects of oblique or transverse partial excision of the A2 pulley on gliding resistance during cyclic motion following zone II flexor digitorum profundus repair in a cadaveric model. J Hand Surg. 2012;37A:1634-8. https://doi.org/10.1016/j.jhsa.2012.05.018
Heithoff SJ, Millender LH, Helman J. Bowstringing as a complication of trigger finger release. J Hand Surg. 1988;13A: 567-70. https://doi.org/10.1016/S0363-5023(88)80097-2
Kato N, Yoshizawa T, Sakai H. Useful MRI assessment for bowstringing of the flexor tendon after trigger finger release. J Orthop Sci. 2014;19(1):186-9. https://doi.org/10.1007/s00776-012-0264-2
Strauch B, de Moura W. Digital flexor tendon sheath: an anatomic study. J Hand Surg. 1985;10A:785-9. https://doi.org/10.1016/S0363-5023(85)80152-0
Momeni A, Grauel E, Chang J. Complications after flexor tendon injuries. Hand Clin. 2009;26:179-89. https://doi.org/10.1016/j.hcl.2009.11.004
Ryzewicz M, Wolf JM. Trigger digits: principles, management, and complications. J Hand Surg. 2006;31A:135-46. https://doi.org/10.1016/j.jhsa.2005.10.013
Rayan GM. Distal stenosing tenosynovitis. J Hand Surg. 1990;15A:973-5. https://doi.org/10.1016/0363-5023(90)90026-N
Seradge H, Kleinert HE. Reduction flexor tenoplasty. J Hand Surg. 1981;6:543-4. https://doi.org/10.1016/S0363-5023(81)80125-6
Yuasa K, Kiyoshige Y. Partial resection of the flexor digitorum superficialis tendon for triggering at the chiasma tendinum. Seikeigeka. 2002;53:1631-3.
Le Viet D, Tsionos I, Bouloundenine M, Hannouche D. Trigger finger treated by ulnar superficialis slip resection (U. S. S. R). J Hand Surg. 2004;29B:368-73. https://doi.org/10.1016/J.JHSB.2004.03.004
Al-Qattan MM. Trigger fingers requiring simultaneous division of the A1 pulley and the proximal part of the A2 pulley. J Hand Surg. 2007;32E(5):521-3. https://doi.org/10.1016/J.JHSE.2007.03.009
Naidu SH, Rinkus K. Multiple-loop, uniform-tension flexor pulley reconstruction. J Hand Surg Am. 2007;32(2):265-8. https://doi.org/10.1016/j.jhsa.2006.11.012
Klauser A, Frauscher F, Bodner G, Halpern EJ, Schocke MF, Springer P, et al. Finger pulley injuries in extreme rock climbers: depiction with dynamic US1. Radiology. 2002;222:755-61. https://doi.org/10.1148/radiol.2223010752
Bodner G, Rudisch A, Gabl M, Judmaier W, Springer P, Klauser A. Diagnosis of digital flexion tendon annular pulley disruption: comparison of high frequency ultrasound and MRI. Ultraschall Med. 1999;20(4):131-6. https://doi.org/10.1055/s-1999-8904
El-Sheikh Y, Wong I, Farrokhyar F, Thoma A. Diagnosis of finger flexor pulley injury in rock climbers: a systematic review. Can J Plast Surg. 2006;14(4):227-31. https://doi.org/10.1177/229255030601400405
Parellada JA, Balkissoon AR, Hayes CW, Conway WF. Bowstring injury of the flexor tendon pulley system: MR imaging. AJR Am J Roentgenol. 1996;167(2):347-9. https://doi.org/10.2214/ajr.167.2.8686601
Hauger O, Chung CB, Lektrakul N, Botte MJ, Trudell D, Boutin RD, Resnick D. Pulley system in the fingers: normal anatomy and simulated lesions in cadavers at MR imaging, CT, and US with and without contrast material distention of the tendon sheath. Radiology. 2000;217:201-12. https://doi.org/10.1148/radiology.217.1.r00oc40201
Erickson SJ, Kneeland B, Middleton WD, Jesmanowicz A, Hyd J, Lawson TL, et al. MR imaging of the finger: correlation with normal anatomic sections. Am J Roentgenol. 1989;152: 1013-9. https://doi.org/10.2214/ajr.152.5.1013
Mehta V, Phillips CS. Flexor tendon pulley reconstruction. Hand Clin. 2005;21:245-51. 35. Kleinert HE, Bennett JB. Digital pulley reconstruction employing the always present rim of the previous pulley. J Hand Surg. 1978;3A:297-8. https://doi.org/10.1016/j.hcl.2004.12.002
Okutsu I, Ninomiya S, Hiraki S, Inanami H, Kuroshima N. Three loop technique for A2 pulley reconstruction. J Hand Surg. 1987;12A:790-4. https://doi.org/10.1016/S0363-5023(87)80071-0
Lister GD. Reconstruction of pulleys employing extensor retinaculum. J Hand Surg Am. 1979;4(5):461-4. https://doi.org/10.1016/S0363-5023(79)80044-1
Widstrom CJ, Johnson G, Doyle JR, Manske PR, Inhofe P. A mechanical study of six digit pulley reconstruction techniques: part I. Mechanical effectiveness J Hand Surg. 1989;14A:821-5. https://doi.org/10.1016/S0363-5023(89)80082-6
Bartle BK, Telepun GM, Goldberg NH. Development of a synthetic replacement for flexor tendon pulleys using expanded polytetrafluoroethylene membrane. Ann Plast Surg. 1992;28(3):266-70. https://doi.org/10.1097/00000637-199203000-00011
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