Trigger Finger of a Distal A2 Pulley

Trigger finger commonly occurs in A1 pulley. However, there have been occasional reports of proximal or distal A2 pulley and A3 pulley at other sites. Especially, trigger finger that occurs in A2 pulley is usually due to thickening of flexor tendon. Flexor tendon plasty surgery or A2 pulley partial release are well known treatments of A2 pulley trigger finger. We conducted pulley lengthening of the A2 pulley to a 62-year-old man who has trigger finger occurring in distal portion of the A2 pulley, and we report about this with good results obtained.

A2 Pulley Reconstruction after Revascularization for Crushing or Amputation Injury of the Hand

PURPOSE: We report the results of A2 pulley reconstruction following revascularization for crushing or amputation injury of the hand. MATERIALS AND METHODS: The A2 pulley reconstruction was performed in 5 patients(5 digits) in whom the flexion of finger is restricted due to loss of the A2 pulley. All the patients underwent replantation or revascularization for the treatment of crushing or amputation injury of hand. Methods for reconstructing pulley were a tendon graft using palmaris longus(3 cases) and extensor retinaculum(2 cases). For assessments, the total active range of motion was measured. RESULTS: Total active range of motion increased by a mean of 39degrees(range, 15~100degrees) after pulley reconstruction. The mean improvement was 44%(range, 12~69%) of the maximum expected motion. CONCLUSION: In patients who underwent replantation or revascularization, the A2 pulley reconstruction after multiple-stage of flexor tendon reconstruction is a way to improve the active range of motion when the finger flexes.