Dorsal view left hand
Dorsal view left hand
Volar view left hand
The flexor tendon of the hand is responsible for finger flexion. The tendon runs through a tunnel called a tendon sheath in the palm and fingers that allow smooth gliding of the tendon as it flexes and extends. Along the flexor tendon there is a pulley system that maintains the tendon position and keeps it close to the underlying bones.
The A1 pulley may become inflamed and/or thickened thereby restricting smooth gliding of the tendon. Over time the tendon may also become inflamed and develop a small nodule on its surface and when this nodule passes through the A1 pulley a sensation of catching is experienced. The obstruction may worsen over time and the finger may be locked and require straightening with help from the other hand.
Green Classifaction | |
Grade I | Hand palm pain & tenderness at A1 pulley |
Grade II | Digit catching |
Grade III | Digit locking with passive correction |
Grade IV | Fixed, locked digit |
LASI for trigger finger
Incision: over pulley
Release A1 pulley sheath
Active wrist ROM after 2 weeks
Finger adduction strengthening
Finger abduction strengthening
Hand grip strengthening