Case of Trigger Finger Related to an Intertendinous Connection between the Flexor Tendons

Abstract

We report a rare cause of trigger finger related to an anatomical variation of an intertendinous connection between the flexor digitorum superficialis and flexor digitorum profundus tendons in the palmar region.

Trigger Fingers Requiring Simultaneous Division of the A1 Pulley and the Proximal Part of the A2 Pulley

“…It should be noted that the pathology in “idiopathic” distal trigger fingers is thickening, or fusiform enlargement, of the flexor tendons. Other isolated cases of “nonidiopathic” distal trigger finger have been reported secondary to rheumatoid synovitis (Helal, 1970), closed rupture of the flexor digitorum superficialis tendon (Rayan and Elias, 1980), open untreated partial lacerations of the flexor profundus tendon (Al-Qattan et al, 1995), congenital intertendinous connection between the superficialis and profundus tendons (Kazuki et al, 2005), and tendon tumours, such as intratendinous ganglia. Surgical treatment of these cases should be directed to the specific pathology.…”

Les doigts à ressort

“…On peut également observer un ressaut après réparation du fait de l'épaississement au niveau de la suture. Enfin, il a été observé de façon encore plus anecdotique un ressaut digital du fait d'une réaction à corps étranger pénétrant ; tumorale : lipome, hémangiome caverneux, ostéochondrome, exostose, chondrome ; infectieuse : toute synovite, par l'encombrement qu'elle induit peut être responsable d'un doigt à ressort, c'est le cas rapporté d'une infection à Mycobacterium kansasii [19] ; variation anatomique [20].…”

Triggering at the Distal A2 Pulley

“…Trigger finger occurs primarily at the A1 pulley and tenosynovitis is the usual cause. However, although rare, triggering of the flexor tendon can occur in other areas and under other conditions (Al-Harthy and Rayan, 2003; Bartell and Shehadi, 1991; Cardon et al, 1999; Frewin and Scheker, 1989; Fujiwara, 2005; Gaffield and Mackay, 2001; Helal, 1970; Kazuki et al, 2005; Laing, 1986; Lee and Pho, 2005; Minami and Ogino, 1986; Moore, 2000; Oni, 1984; Rankin and Reid, 1985; Rayan, 1990; Seradge and Kleinert, 1981; Sherman and Lane, 1996; Smith et al, 1998; Stockley and Norris, 1990; Takami et al, 1993).…”