Case ReportNo Access

Recurrent Trigger Finger Caused by Herniation of Flexor Digitorum Profundus through the Chiasma – A Case Report

Sarah K. TOLERTON

Department of Hand Surgery and Peripheral Nerve Surgery, North Shore Private Hospital, Sydney, Australia

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Brahman S. SIVAKUMAR

Department of Hand Surgery and Peripheral Nerve Surgery, North Shore Private Hospital, Sydney, Australia

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, and

Richard D. LAWSON

Department of Hand Surgery and Peripheral Nerve Surgery, North Shore Private Hospital, Sydney, Australia

E-mail Address: NSLHD-Handsurgery@health.nsw.gov.au

Correspondence to: Dr. Richard Lawson, Department of Hand Surgery & Peripheral Nerve Surgery, Royal North Shore Hospital, North Shore Private Hospital, St Leonards, 2065 Australia. Tel: +61-2-9463-1820.

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https://doi.org/10.1142/S2424835522720365Cited by:1 (Source: Crossref)

Abstract

Trigger digit is a common condition which is largely idiopathic in etiology. Less frequently, it has been described secondary to anatomical variations or space occupying lesions. We describe a patient who developed a recurrent trigger finger after a surgical release of the first annular pulley. Intraoperatively, the trigger was noted to be caused by herniation of the flexor digitorum profundus (FDP) tendon into a noose formed by the two slips of the flexor digitorum superficialis tendon (FDS) and the proximal edge of the second annular pulley.

Level of Evidence: Level V (Therapeutic)

Keywords:

REFERENCES

1. Ryzewicz M, Wolf JM. Trigger digits: Principles, management, and complications. J Hand Surg Am. 2006;31(1):135–146. https://doi.org/10.1016/j.jhsa.2005.10.013. Crossref, Google Scholar
2. Laing PW. A tendon tumour presenting as a trigger finger. J Hand Surg Br. 1986;11(2):275. https://doi.org/10.1016/0266-7681(86)90283-4. Crossref, Google Scholar
3. Rockey H. Trigger-finger due to a tenosynovial osteochondroma. J Bone Joint Surg. 1963;45(2):387–388. https://doi.org/10.2106/00004623-196345020-00020. Crossref, Google Scholar
4. Frewin PR, Scheker LR. Triggering secondary to an untreated partially-cut flexor tendon. J Hand Surg Br. 1989;14(4):419–421. https://doi.org/10.1016/0266-7681(89)90159-9. Crossref, Google Scholar
5. Gordon SL. Late rupture of one slip on the floor digitorum superficialis: An unusual cause of triggering. Clin Orthop Relat Res. 1981;(158):142–143. https://doi.org/10.1097/00003086-198107000-00022. Crossref, Google Scholar
6. Nagaoka M, Yamaguchi T, Nagao S. Triggering at the distal A2 pulley. J Hand Surg Eur Vol. 2007;32(2):210–213. https://doi.org/10.1016/J.JHSB.2006.11.004. Crossref, Google Scholar
7. Walbeehm ET, McGrouther DA. An anatomical study of the mechanical interactions of flexor digitorum superficialis and profundus and the flexor tendon sheath in zone 2. J Hand Surg Br. 1995;20(3):269–280. https://doi.org/10.1016/s0266-7681(05)80077-4. Crossref, Google Scholar
8. Le Viet D, Tsionos I, Boulouednine M, Hannouche D. Trigger finger treatment by ulnar superficialis slip resection (U.S.S.R.). J Hand Surg Br. 2004;29(4):368–373. https://doi.org/10.1016/j.jhsb.2004.03.004. Crossref, Google Scholar
9. Ferlic DC, Clayton ML. Flexor tenosynovectomy in the rheumatoid finger. J Hand Surg Am. 1978;3(4):364–367. https://doi.org/10.1016/s0363-5023(78)80039-2. Crossref, Google Scholar
10. Wheen DJ, Tonkin MA, Green J, Bronkhorst M. Long-term results following digital flexor tenosynovectomy in rheumatoid arthritis. J Hand Surg Am. 1995;20(5):790–794. https://doi.org/10.1016/S0363-5023(05)80433-2. Crossref, Google Scholar