Challenge of the Week / Hand & Wrist / 11.08.19

A 12-year-old female patient has triggering of her long finger that has persisted despite nonoperative measures. The patient and her parents are ready to proceed with operative intervention. In addition to release of the A1 pulley, which of the following operative interventions will most likely be necessary?
  • Release of the A3 pulley
  • Release of the A3 pulley is not routinely indicated in pediatric patients with trigger finger.

  • Excision of a slip of the flexor digitorum superficialis tendon
  • Pediatric patients with trigger finger are treated with release of the A1 pulley and excision of a slip of the flexor digitorum superficialis.

  • Tenolysis of the flexor tendons
  • Excision of a slip of the flexor digitorum superficialis should be performed after A1 pulley release in a pediatric patient with a trigger finger.

  • Release of the lumbrical
  • Release of the lumbrical is not routinely indicated in pediatric patients with a trigger finger.

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