A1 pulley stretching treats trigger finger: A1 pulley luminal region under digital flexor tendon traction. (February 2020)

• Record Type: Journal Article
• Authors: Yamazaki, Atsuro; Matsuura, Yusuke; Kuniyoshi, Kazuki; Suzuki, Takane; Akasaka, Tomoyo; Ozone, Ei; Matsuyama, Yoshiyuki; Mukai, Michiaki; Yamazaki, Takahiro; Ohara, Takeru; Sasho, Takahisa; Ohtori, Seiji
• Is Part Of: Clinical biomechanics. Volume 72(2020)
• Page Start: 136
• Page End: 140
• Publication Date: 2020-02
• Subjects: Trigger finger -- Conservative therapy -- A1 pulley stretching -- Cadaveric anatomical study; Biomechanics -- Periodicals; Osteopathic medicine -- Periodicals; Biomechanics -- Periodicals; Osteopathic Medicine -- Periodicals; 612.76
• DOI: 10.1016/j.clinbiomech.2019.11.018
• Languages: English
• ISSNs: 0268-0033

Abstract

Abstract: Background: A1 pulley stretching is recognized as a clinically beneficial treatment for trigger finger. It is thought to lead to an increase in the cross-sectional area of the A1 pulley luminal region, thus improving trigger finger symptoms. The purpose of the present study was thus to evaluate the resultant forces during stretching that increase the CSA of the A1 pulley luminal region using fresh-frozen cadavers. Methods: Using seven fingers from three fresh-frozen cadavers to replicate A1 pulley stretching, we investigated the resultant forces during stretching that increase the cross-sectional area of the A1 pulley luminal region. The traction forces of the flexor digitorum profundus tendons were increased in steps to 150 N, and the cross-sectional area and height of the A1 pulley luminal region were measured using ultrasonography. Findings: The cross-sectional area of the A1 pulley luminal region increased with step-wise increases in the flexor digitorum profundus traction. On average, the cross-sectional area and height of the A1 pulley luminal region showed increases of 31.4% and 43.6%, respectively, compared to the unloaded condition. Interpretation: These results confirmed that A1 pulley stretching increases the cross-sectional area of the A1 pulley luminal region. A1 pulley stretching has the potential to reduce the severity of trigger finger in patients facing surgery. Highlights: A1 pulley stretching is recognized as a clinically beneficial treatment for trigger finger. A1 pulley stretching was confirmed to increases the cross-sectional area of the A1 pulley luminal region using cadavers. A1 pulley stretching has the potential to reduce the severity of trigger finger.