A 35-year-old woman presents with a trigger finger (stenosing tenosynovitis) of the right ring finger that has failed two corticosteroid injections. The pathological site of tendon catching is at:

• A The A1 pulley ✓
• B The A2 pulley
• C The cruciform (C) pulleys
• D The flexor digitorum superficialis chiasma of Camper

Explanation

Trigger finger results from hypertrophy and nodular thickening of the flexor tendon at the level of the A1 pulley (at the MCP joint level), which creates a size mismatch between the pulley and tendon. During percutaneous or open trigger finger release, the A1 pulley is divided. The A2 and A4 pulleys are the critical biomechanical pulleys and must be preserved to prevent bowstringing of the flexor tendons.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.