title: Resection of the flexor digitorum superficialis for trigger finger with proximal interphalangeal joint positional contracture.
abstract: OBJECTIVE
  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° (range, 15°-30°). The mean postoperative positional contracture of the PIP joint was 4° (range, 0°-10°). 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°-10°). 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.
authors.affiliation: Clinique du Parc Léopold, Centre de Chirurgie de la Main, Bruxelles, Belgium. yannfavre@bluewin.ch
authors.forename: Yann
authors.initials: Y
authors.lastname: Favre
authors.forename: Louis
authors.initials: L
authors.lastname: Kinnen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003286:Contracture / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005384:Finger Joint / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008023:Ligaments, Articular / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D052582:Trigger Finger Disorder / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*