Rodriguez Fontan Francisco, Laynes Renzo, Scott Frank
Faculty of Medicine, Universidad de Buenos Aires, Buenos Aires, ARG.
Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, USA.
Cureus. 2024 May 28;16(5):e61250. doi: 10.7759/cureus.61250. eCollection 2024 May.
A 59-year-old woman, who previously underwent surgery on her left long finger A1 pulley and left small finger distal interphalangeal joint for triggering and mallet deformity at another medical facility in March 2021, sought evaluation at an Orthopedics Hand clinic. She presented with limited finger movement, a flexion contracture, and difficulty extending her left long finger. Examination revealed an A2 pulley injury with extensive scar tissue. Subsequently, she underwent surgery to remove the scar tissue and reconstruct the A2 pulley using suture tape anchors. This case highlights the negative outcome following A1 pulley release due to an unintended A2 injury, resulting in significant scarring and an intrinsic plus digit posture. Additionally, it underscores the potential effectiveness of using non-absorbable synthetic sutures to minimize scarring and promote an early range of motion in cases where healing leads to excessive scarring around the flexor tendon sheath.
一名59岁女性，2021年3月在另一家医疗机构因扳机指和锤状指畸形接受了左手环指指A1滑车和左手小指远侧指间关节手术，现到骨科手部诊所求诊。她表现为手指活动受限、屈曲挛缩，左手环指伸展困难。检查发现A2滑车损伤并有广泛瘢痕组织。随后，她接受了手术，切除瘢痕组织并用缝线带锚钉重建A2滑车。该病例突出了因意外的A2损伤导致A1滑车松解后的不良后果，造成明显瘢痕形成和内在肌紧张性手指姿势。此外，它强调了在屈肌腱鞘愈合导致过度瘢痕形成的情况下，使用不可吸收合成缝线以尽量减少瘢痕形成并促进早期活动范围的潜在有效性。
