METHODS: A prospective study was conducted from January 2018 to June 2019, involving patients with grade II-III trigger finger requiring surgical intervention. Patients were randomized into two groups: group I (open A1 pulley release with flexor tendon traction tenolysis) and group II (open A1 pulley release without flexor tendon traction tenolysis). Postoperative assessments were conducted at 2 weeks, 2 months, and 4 months, documenting finger range of motion, QuickDASH scores, complications, and surgery duration.

RESULTS: A total of 50 patients met the selection criteria, with 46 completing the study. The majority were women, with an average age of 56 ± 9.6 years. The patients were predominantly diabetic with the condition affecting the left hand and middle finger and presenting as grade III trigger finger. Baseline characteristics, including age, gender (female/male), ethnicity, occupational status, diabetes status, and trigger finger severity, were comparable between the two groups. Preoperative QuickDASH scores were also similar. The mean preoperative finger range of motion at the metacarpophalangeal and proximal interphalangeal joint were lower in group I but were not statistically important. Patients in group I exhibited consistently better postoperative finger range of motion and QuickDASH scores compared to group II throughout the follow-up period. The difference was statistically important at the 2-week follow-up. Although group I continued to show better outcomes at 2 and 4 months, the differences were not statistically important. Surgery duration was importantly longer in group I (16.4 ± 5.7 minutes) compared to group II (11.43 ± 3.8 minutes). Two patients in group I experienced wound infections, which resolved with a week-long course of antibiotics.

CONCLUSIONS: Open A1 pulley release with flexor tendon traction tenolysis resulted in better early postoperative (2 weeks) finger flexion range of motion and QuickDASH scores, albeit with a longer surgery duration.

PURPOSE: This study aims to assess the precision of ultrasound in identifying upper limb peripheral nerves by comparing ultrasonographic findings with direct human cadaveric dissection.

METHOD: Fourteen fresh-frozen upper limb specimens were examined in February 2023. Ultrasound assessments were performed by two experienced musculoskeletal radiologists using three linear probes (15 MHz, 24 MHz, and a 22 MHz hockey stick probe). Seven peripheral nerves were identified and marked using dye injections. Subsequent dissections were conducted under loupe magnification by hand surgeons.

RESULT: The recurrent motor branch of the median nerve exhibited the lowest discrepancy (mean 1.014 ± 1.459 mm) and the highest accuracy (64.29% of specimens). The greatest discrepancy was observed in the branch of the musculocutaneous nerve to the brachialis (mean 5.114 ± 3.758 mm). The interrater correlation coefficient (ICC) varied across nerve sites, ranging from - 6.298 to 0.795, with the highest ICC observed in the superficial branch of the ulnar nerve (0.795, 0.066).