80 Participants Needed

A1 Pulley Surgery Techniques for Trigger Finger

Recruiting at 5 trial locations
Eric Wagner, MD, MS profile photo
Overseen ByEric Wagner, MD, MS
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Emory University
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial compares two surgical methods for treating trigger finger: removing or cutting a part of the tendon sheath. It focuses on patients who haven't improved with other treatments. The goal is to see which method better reduces pain and stiffness by helping the tendon move more freely.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with your doctor or the study team.

Is A1 pulley surgery for trigger finger generally safe?

A1 pulley surgery for trigger finger is generally considered safe, with most complications being minor, such as scar pain and tenderness. Major complications like nerve or blood vessel injury and infection are rare, occurring in less than 1% to 4% of cases.12345

How does A1 pulley surgery for trigger finger differ from other treatments?

A1 pulley surgery for trigger finger involves either excising (removing) or incising (cutting) the A1 pulley to relieve symptoms. This treatment is unique because it directly addresses the mechanical issue causing the finger to lock, unlike other options like corticosteroid injections, which aim to reduce inflammation. Additionally, newer techniques like nonpalmar endoscopic release may offer benefits such as less scarring and faster recovery compared to traditional open surgery.13678

What data supports the effectiveness of the treatment A1 Pulley Surgery Techniques for Trigger Finger?

Open release of the A1 pulley for trigger finger is generally considered a minor procedure with a low rate of major complications, less than 1% to 4%, and is widely known for its effectiveness in treating trigger finger.12368

Who Is on the Research Team?

Dr. Eric R Wagner, MD, MSc - Atlanta ...

Eric Wagner, MD, MS

Principal Investigator

Emory University

Are You a Good Fit for This Trial?

This trial is for adults over 18 with trigger finger syndrome who are undergoing surgery and can give informed consent. It excludes those unable to consent, minors, pregnant women, and prisoners.

Inclusion Criteria

I am having surgery for trigger finger.
I am willing and able to agree to participate in the study.

Exclusion Criteria

Pregnant women
I am under 18 years old.
I am unable to give consent for medical procedures.
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Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo surgical treatment with either excision or incision of the A1 pulley for trigger finger

1 day
1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment, with assessments at multiple time points

1 year
Visits at 2 weeks, 6 weeks, 3 months, 6 months, and 1 year (in-person)

What Are the Treatments Tested in This Trial?

Interventions

  • Excision of the A1 pulley
  • Incision of the A1 pulley in the standard fashion
Trial Overview The study compares two surgical treatments for trigger finger: excision (complete removal) versus incision (cutting) of the A1 pulley. The goal is to see which method offers better pain relief, less stiffness, and lower recurrence rates.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: excision of the A1 pulleyExperimental Treatment1 Intervention
Group II: incision of the A1 pulley in the standard fashionActive Control1 Intervention

Excision of the A1 pulley is already approved in United States, European Union for the following indications:

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Approved in United States as A1 Pulley Release for:
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Approved in European Union as Trigger Finger Release for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Emory University

Lead Sponsor

Trials
1,735
Recruited
2,605,000+

Published Research Related to This Trial

In a study of 43 patients who underwent 78 open trigger finger releases, the major complication rate was found to be low at 3%, with only two cases requiring further intervention.
However, the minor complication rate was notably high at 28%, with issues such as decreased range of motion and scar tenderness being common, indicating that patients should be informed about these potential outcomes.
Complications of open trigger finger release.Will, R., Lubahn, J.[2010]
Patients treated with a nonpalmar endoscopic approach for trigger finger showed significantly better scar outcomes compared to those who underwent standard open surgery, particularly noticeable at 1 week and 1 month post-operation.
Both techniques were equally effective in treating trigger finger, with the endoscopic group returning to work sooner and reporting higher overall satisfaction, although these differences were not statistically significant.
Nonpalmar Endoscopic versus Open Trigger Finger Release: Results from a Prospective Trial.Brown, AM., Tanabe, KL., DellaMaggiora, RJ., et al.[2022]
In a case series of three patients who underwent open A1 pulley release for trigger finger, all developed severe postoperative infections that led to significant complications, including flexor tenosynovitis and the need for multiple surgeries.
Despite the rarity of major complications (less than 1% to 4%), this study emphasizes that untreated infections, especially in diabetic patients, can result in permanent functional deficits, highlighting the need for prompt diagnosis and treatment of postoperative infections.
Not Just Another Trigger Finger.Effendi, M., Yuan, F., Stern, PJ.[2023]

Citations

Complications of open trigger finger release. [2010]
Nonpalmar Endoscopic versus Open Trigger Finger Release: Results from a Prospective Trial. [2022]
Not Just Another Trigger Finger. [2023]
Resection of the flexor digitorum superficialis for trigger finger with proximal interphalangeal joint positional contracture. [2022]
Percutaneous release, open surgery, or corticosteroid injection, which is the best treatment method for trigger digits? [2021]
Percutaneous release of the A1 pulley: a cadaver study. [2022]
A cadaveric assessment of percutaneous trigger finger release with 15° stab knife: its effectiveness and complications. [2021]
Complete annular and partial oblique pulley release for pediatric locked trigger thumb. [2022]
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