gms | German Medical Science

Objectives/Interrogation: A frequently performed operation, release of A1 pulley for triggering fingers and thumbs usually results in high patient satisfaction. In this study we aimed to assess its effect on grip and pinch strengths.

Methods: This prospective cohort study was performed in 26 patients who were operated between March 2016 and May 2018. There were 17 women and 9 men. The mean age of the patients was 53 (min=17, max=71). A total of 30 A1 pulley releases were performed (in 9 thumb, 1 index, 12 middle and 8 ring fingers). All of the operations were performed under local anesthesia using transverse skin incisions. Grip and tip-to-tip pinch strengths were recorded both pre-operatively and 3 months after the surgery. To compare pre and postoperative strengths, Wilcoxon and paired samples t-tests were used for grasp and pinch values, respectively.

Results and Conclusions: Both grip and pinch strengths showed statistically significant (p<0.05) increases postoperatively. Regarding details, grip strength increased in 23 hands while in 2 hands decreased and in one hand remained the same. Pinch strength increased in 28 fingers of 24 patients while decreased in one and remained the same in another patient.

When we planned the study, we had hypothesized that A1 pulley release might lead to loss of grip and/or pinch forces by an increase in bowstring effect of flexor tendons. Verifying the part of our hypothesis about the increase in bowstring, Park et al in their recently published article state that ultrasonography shows significant bowstring of flexor tendons at 12th week postoperatively. Due to our results, the probable increase in bowstring of flexor tendons have no adverse effect on pinch and grip strengths at 3rd postoperative month. We think that the main reason of significant increase in grip and pinch strengths which we found in our patient group after release of triggering fingers might be due to recovery from the painful condition.