Incision Decision: A Prospective Randomized Trial Comparing Longitudinal vs. Transverse A1 Pulley Release Outcomes
Washington University School of Medicine
Summary
The goal of this clinical trial is to compare two different skin incisions used in surgery to treat trigger finger in adult patients. Trigger finger occurs when a finger gets stuck or locks because of swelling of the sheath around the tendons the help move the fingers. The main questions it aims to answer are (1) Does the type of skin cut affect how well the hand works 6 weeks after surgery? (2) Does the type of skin cut affect pain levels, scar healing, and how quickly people return to their normal activities? Orthopaedic surgeons will compare a straight incision along the finger (longitudinal incision) to a incision across the crease in the palm (transverse incision) to see if one type of incision results in better recovery, less pain, a better scar, and higher patient satisfaction with the procedure. Participants who have trigger finger and are indicated for surgery will have surgery to release the pulley in their finger using one of the two types of incisions (assigned by chance). Participants will fill out questionnaires about their hand function and pain before surgery and at follow-up visits. Participants will have their scar checked and rated at about 2, 6, and 12 weeks after surgery, and report on their pain for the first few days after surgery and when they can return to work and move their finger without pain.
Description
This is a prospective, multicenter, randomized controlled trial comparing clinical and patient-reported outcomes between longitudinal and transverse incisions for open A1 pulley release in the treatment of idiopathic trigger finger (stenosing tenosynovitis of the fingers, excluding the thumb). Stenosing tenosynovitis of the flexor tendon, commonly known as trigger finger, is a frequent hand condition with a lifetime incidence of approximately 2.6%. It results from inflammation and a size mismatch between the flexor tendon and the first annular (A1) pulley, leading to painful catching, clicking…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Adult patients (age ≥ 18 years) * Diagnosed with trigger finger (stenosing tenosynovitis) of a finger (excluding the thumb) * Written informed consent obtained Exclusion Criteria: * Revision surgery * Previous surgery on the affected finger * Patients refusing consent
Interventions
- ProcedureOpen A1 Pulley Release
Surgical release of the first annular (A1) pulley to treat stenosing tenosynovitis (trigger finger). Participants receive either a longitudinal or transverse incision based on their randomized arm assignment. All other aspects of surgical technique and post-operative care are standardized.
Locations (2)
- The University of Chicago MedicineChicago, Illinois
- Washington University and Barnes-Jewish Orthopedic CenterSt Louis, Missouri