Surgical Treatment of Stenosing Tenosynovitis: Early and Late Outcomes, Complications

Abstract

Background. The thickening of A1 pulley of the tendon sheath limits the excursion of flexor tendon. Stenosing tenosynovitis causes finger movements dysfunction and pain. Objective. To analyze early and late outcomes of patients with stenosing tenosynovitis after surgical treatment – anulotomy. Methods. All patients had standard surgical procedure – open anulotomy of A1 pulley. Pain (verbal pain scale), hand and arm function (QuickDASH) and complications were recorded before surgery, after 1 week, 3 months and 6 months post surgery. Results. There were 45 patients, 29 (64%) female, 16 (36%) male. The highest pain score was recorded before surgery median 5 (IQR 5). The lowest pain score median 2 (IQR 2) was recorded after 6 months post surgery. The difference of the results after 1 week, 3 months and 6 months was statistically significant p < 0.001. The worst hand and arm function was before surgery and 1 week post surgery. Accordingly: medians 52 (IQR 33) and 52 (IQR 35). Full hand function recovery was noticed after 6 months post surgery median 0 (IQR 11). The difference is statistically significant p < 0.001. Conclusions. Surgical treatment, open anulotomy is one of the most effective methods for stenosing tenosynovitis. After this procedure pain and hand function improves greatly. However, for some patients it might cause discomfort of the hand because of the scar’s sensitivity and location.