Department of Orthopedic Surgery, Research Institute of Clinical Medicine of Jeonbuk National University - Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Jeonbuk, Republic of Korea.
Medicine (Baltimore). 2022 Jul 22;101(29):e29663. doi: 10.1097/MD.0000000000029663.
When surgical treatment is indicated for primary trigger finger, open A1 pulley release has traditionally been recommended with generally good results. However, ganglion cysts of the flexor tendon sheath as a complication after an open A1 pulley release were rarely reported. Therefore, the purpose of this study is to report a case of multiple ganglion cysts arising from the flexor tendon sheath in a patient undergoing an open A1 pulley release for trigger finger disorder with a review of the relevant literature.
A 65-year-old right-handed farmer was referred to our hospital for swelling in the left long finger (LLF). One year before the visit, the patient was diagnosed with trigger finger in the LLF at other hospital and an open A1 pulley release was performed, but the swelling of the finger persisted. The patient had no history of trauma or evidence of systemic disease such as rheumatoid or other inflammatory arthritis. The patient was diagnosed with multiple ganglion cysts of flexor tendon sheath after investigation.
We successfully excised cystic masses and debrided the partially ruptured flexor digitorum superficialis (FDS) tendon and sutured it using 5/0 prolene. At 12-month follow-up, the patient was completely asymptomatic with excellent range of motion in the distal interphalangeal (DIP) joint (0°-60°) of his LLF, showing no recurrence of ganglion cyst.
Trigger finger is a common condition that clinicians encounter frequently. However, this familiarity may lead to inattentive treatment. Nevertheless, through this case, clinicians should devote careful attention when performing open A1 pulley release to prevent partial rupture of the flexor tendon in the A1 pulley. If ganglion cysts occur, we believe that surgical excision can yield good results.
当原发性扳机指需要手术治疗时，传统上推荐行开放 A1 滑车切开松解术，通常效果良好。然而，开放 A1 滑车切开松解术后发生屈肌腱鞘腱鞘囊肿作为一种并发症的情况很少有报道。因此，本研究旨在报告 1 例因扳机指行开放 A1 滑车切开松解术后发生屈肌腱鞘多发腱鞘囊肿的病例，并复习相关文献。
1 名 65 岁右利手农民因左手示指（LLF）肿胀就诊于我院。就诊前 1 年，患者在其他医院被诊断为左 LLF 扳机指，并接受了开放 A1 滑车切开松解术，但手指肿胀持续存在。患者无外伤史，也无类风湿或其他炎性关节炎等系统性疾病的证据。经过检查，患者被诊断为多发屈肌腱鞘腱鞘囊肿。
我们成功切除了囊性肿块，对部分撕裂的指浅屈肌腱（FDS）进行清创，并使用 5/0 prolene 缝合。在 12 个月的随访中，患者完全无症状，左手 LLF 的远侧指间关节（DIP）活动度良好（0°-60°），无腱鞘囊肿复发。
扳机指是一种常见的疾病，临床医生经常遇到。然而，这种熟悉可能会导致治疗不注意。尽管如此，通过这个病例，临床医生在进行开放 A1 滑车切开松解术时应格外注意，以防止 A1 滑车中的屈肌腱部分撕裂。如果发生腱鞘囊肿，我们认为手术切除可以取得良好的效果。
