Comparison of Two Surgical Techniques for the Treatment of Trigger Fingers: Longitudinal Opening Versus Complete A1 Pulley Release

NCT07497061 | Not Yet Recruiting

• 1 other identifier: 2026-13176
• Study Type: interventional
• Target: 236
• Locations: 0 countries
• Sites: N/A

Brief Summary

Trigger finger is a pathology of the flexor tendons caused by inflammation of the tendon or its sheath, leading to pain, nodules, fibrosis, and limited mobility. Surgical treatment aims to release the space at the level of the A1 pulley, either through longitudinal opening (the standard technique, but associated with recurrence rates of approximately 7.7%) or through complete resection, an emerging approach that may reduce recurrences and the need for reoperations. However, comparative data remain limited, justifying further investigation. This project therefore aims to compare these two surgical techniques to determine which one results in the lowest recurrence rate and to assess their functional outcomes (pain, range of motion). The primary hypothesis is that A1 pulley resection reduces recurrences after one year, while the secondary hypothesis is that there is no significant difference in postoperative pain or mobility.

Conditions

Trigger Digit; Trigger Finger

Keywords

A1 pulley resection; surgical technique for trigger finger; longitudinal opening of the A1 pulley

Outcome Measures

Primary Outcomes (1)

• Compare trigger finger recurrences between longitudinal A1 pulley release surgery and complete A1 pulley resection surgery

  The diagnostic method will be clinical evaluation. It will be based on the patient's clinical history, including the presence of a painful 'click' during finger movement, a finger that occasionally locks in flexion, pain over the A1 pulley, and/or a palpable nodule at the level of the A1 pulley. The primary outcome will be assessed by an independent, blinded evaluator who did not participate in the surgery and is unaware of the patient's allocation. If necessary, the evaluator will verify the limitation by placing the dorsal surface of the patient's hand on the table and asking the patient to make a fist (flexion) and then open the hand (extension): the inability of the affected finger to remain in a flexed position will confirm the diagnosis. No score, tool, or scale is required for diagnosis, as recurrence is a binary variable that is either present or absent.

  One year after surgery

Secondary Outcomes (2)

• Persistence of pain to the operated finger

  1 week, 4 weeks and one year after surgery

• Range of motion of the operated finger

  1 week, 4 weeks and one year after surgery

Study Arms (2)

A1 pulley resection

EXPERIMENTAL

Complete resection

Procedure: Complete resection

longitudinal opening of the A1 pulley

ACTIVE COMPARATOR

Longitudinal incision

Procedure: Longitudinal incision

Interventions

Longitudinal incision PROCEDURE

A longitudinal incision of the A1 pulley performed to open the pulley, thereby reducing the pressure on the inflamed tendon and facilitating its gliding during finger movements.

longitudinal opening of the A1 pulley

Complete resection PROCEDURE

Fully removing the pulley in order to eliminate friction between the tendon and its fibrous band

A1 pulley resection

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients requiring surgical intervention for the treatment of a trigger finger
• Patients able to provide informed consent

You may not qualify if:

• History of surgery for trigger finger correction on the same finger
• Patients requiring simultaneous surgery for more than one trigger finger

Sponsors & Collaborators

• Centre hospitalier de l'Université de Montréal (CHUM): lead

MeSH Terms

Conditions

Trigger Finger Disorder

Condition Hierarchy (Ancestors)

Tendon Entrapment; Tendinopathy; Muscular Diseases; Musculoskeletal Diseases

Central Study Contacts

Johnny I Efanov, MD, PhD

CONTACT

514-890-8000; ionut.efanov.med@ssss.gouv.qc.ca

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 23, 2026
• First Posted: March 27, 2026
• Study Start: April 1, 2026
• Primary Completion (Estimated): April 1, 2029
• Study Completion (Estimated): April 1, 2029
• Last Updated: March 31, 2026

Record last verified: 2026-03