HTH

Sheila


26 Patienten mit persistierenden Beschwerden wurde operativ das ***A1-Ringband des Daumens*** gespalten. Eine freie aktive und passive Gelenkbeweglichkeit im Seitenvergleich trat bei 92,7 % der Patienten auf, wobei aufgrund einer inkompletten Ringbandspaltung bei 2 Patienten eine erneute Operation durchgeführt wurde. Bei adäquater Diagnostik, frühzeitiger Indikationsstellung und exakter Operationstechnik sollten heutzutage ästhetische und funktionelle Beeinträchtigungen der Hand aufgrund einer Tendovaginitis stenosans beim Kind nicht mehr auftreten.

In 26 patients with persistent symptoms, the A1 ring ligament of the thumb was cut. Free active and passive joint motion was comparable to the opposite side in 92.7 % of patients. In 2 cases a secondary operation was necessary because of incomplete A1 ring ligament release. If it is diagnosed and operated on early with a careful operative technique, nowadays no aesthetic or functional impairment should occur in children because of trigger thumb.

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Note added at 2003-02-17 11:58:46 (GMT)
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I think the correct term may be \'pulley\' and not \'ring ligament\'.

HTH


In the thumb, similar to the A2 and A4 pulleys in the fingers, the oblique pulley is sacrosanct. Because of the obliquity of the oblique ligament and ulnar takeoff, the A1 pulley in the thumb is best divided radially. This is important when surgical release of a trigger thumb is performed. No pulley should be incised during the course of tendon repair, with exception of the A1, A3, and A5 pulleys. Repair is impossible due to the snug fit and the transverse orientation of the fibers.


http://www.emedicine.com/plastic/topic331.htm

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Note added at 2003-02-17 11:59:53 (GMT)
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Patients usually complain of pain over the palm, often over the ring finger. Many patients will point to the middle joint of the finger or the last joint of the thumb as the source of pain. However, the problem is almost invariably at the ***\"A1\" pulley at the base of the finger or thumb on the palm***. Multiple fingers and/or the thumb can be involved. \"Popping\" sensations and pain frequently radiate to the digit, and the digit may lock in a bent position, particularly during sleep. The congenital form is diagnosed by an inability to straighten the digit(s) even with force. X-rays are usually not revealing but may indicate the presence or absence of arthritis, which may be a contributing factor.

http://www.arthroscopy.com/sp04014.htm

deep transverse metacarpal ligaments