• Medicine · Jul 2022

    Review Case Reports

    Formation of multiple ganglion cysts along the flexor tendon after open A1 pulley release for trigger finger: A case report.

    • Young Keun Lee.
    • Department of Orthopedic Surgery, Research Institute of Clinical Medicine of Jeonbuk National University - Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Jeonbuk, Republic of Korea.
    • Medicine (Baltimore). 2022 Jul 22; 101 (29): e29663e29663.

    RationaleWhen surgical treatment is indicated for primary trigger finger, open A1 pulley release has traditionally been recommended with generally good results. However, ganglion cysts of the flexor tendon sheath as a complication after an open A1 pulley release were rarely reported. Therefore, the purpose of this study is to report a case of multiple ganglion cysts arising from the flexor tendon sheath in a patient undergoing an open A1 pulley release for trigger finger disorder with a review of the relevant literature.Patient Concerns And DiagnosisA 65-year-old right-handed farmer was referred to our hospital for swelling in the left long finger (LLF). One year before the visit, the patient was diagnosed with trigger finger in the LLF at other hospital and an open A1 pulley release was performed, but the swelling of the finger persisted. The patient had no history of trauma or evidence of systemic disease such as rheumatoid or other inflammatory arthritis. The patient was diagnosed with multiple ganglion cysts of flexor tendon sheath after investigation.Intervention And OutcomesWe successfully excised cystic masses and debrided the partially ruptured flexor digitorum superficialis (FDS) tendon and sutured it using 5/0 prolene. At 12-month follow-up, the patient was completely asymptomatic with excellent range of motion in the distal interphalangeal (DIP) joint (0°-60°) of his LLF, showing no recurrence of ganglion cyst.LessonsTrigger finger is a common condition that clinicians encounter frequently. However, this familiarity may lead to inattentive treatment. Nevertheless, through this case, clinicians should devote careful attention when performing open A1 pulley release to prevent partial rupture of the flexor tendon in the A1 pulley. If ganglion cysts occur, we believe that surgical excision can yield good results.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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