Outcome of Traction Tenolysis in Open Trigger Finger Release — A Retrospective Review

Abstract

Surgical treatment for trigger finger involves division of the A1 pulley. Some surgeons perform an additional step of traction tenolysis by sequentially bringing the flexor digitorum superficialis and flexor digitorum profundus tendons out of the wound gently with a Ragnell retractor. There is currently no study which states whether flexor tendon traction tenolysis should be routinely performed or not. The objective of this study is to compare the outcome in patients who have traction tenolysis performed (A group) versus those who did not have traction tenolysis (B group) performed. It was noted that even though the mean total active motion (TAM) for the B group in our study was lower preoperatively, it was consistently higher than the A group in all the 3 post-operative visits demonstrating a better outcome in the B group. Even though it was not statistically significant, our data also showed that patients with traction tenolysis appeared to have more postoperative pain compared to those without.

Surgical Treatment and Rehabilitation of Trigger Thumb and Finger

“…In this study, cases of trigger thumb and fingers were more common in women aged 51 to 60 and involved the thumb and fingers III and IV, which is consistent with other reports (Cakmak, Wolf, Bruckner, Hahn, Unglaub, 2012;Choudhury, Tay, 2013;Lange-Riess, Schuh, Honle, Schuh, 2009;Moriya, Uchiyama, Kawaji, 2005). Surgical treatment of trigger thumb and finger is indicated by lack of improved results following conservative treatment.…”

“…The majority (84%) of patients were very satisfied with the treatment. Choudhury and Tay (2013) found that 25 months following surgery 216 thumbs and fingers had achieved average mobility 84% according to TAM. One patient experienced minor wound dehiscence.…”

Tendinosis in Trigger Finger

“…Some surgeons perform an additional step of traction tenolysis, by bringing the FDS and FDP tendons out of the wound 218 . However, a tendency to lower postoperative total active motion and more pain is reported after this, suggesting restraint.…”