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Journal of Hand Surgery (European Volume)
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Articles

Histopathology of the A1 Pulley in Adult Trigger Fingers

M. C. SBERNARDORI
P. BANDIERA

From the Department of Orthopaedics, University School of Medicine, Sassari, Italy and the Department of Biomedical Sciences and Division of Human Anatomy, University School of Medicine, Sassari, Italy

Correspondence: Dr. M. Chiara Sbernardori, Department of Biomedical Sciences, Division of Human Anatomy, Viale San Pietro no. 43/C, 07100 Sassari, Italy. Tel.: +39 79 22 85 13; fax: +39 79 22 85 36. E-mail:mcsbernardori{at}tiscalinet.it

The histopathology of the central parts of 40 A1 pulleys from adult patients with primary trigger fingers was studied using light and transmission electron microscopes and the findings were compared with those in a control series of 10 normal A1 pulleys. The evaluation of the normal A1 pulley revealed a bi-laminar structure. The deepest layer was composed of dense normal connective tissue. The outermost layer was formed by loose connective tissue. In trigger digits, it was possible to identify a tri-laminar structure. The deepest layer was composed of irregular connective tissue, formed by small collagen fibres and abundant extracellular matrix. A considerable amount of chondroid-metaplasia was present in this layer. The middle layer contained dense, normal connective tissue with some fibrocytes. The outermost layer was formed of loose connective tissue. In conclusion, there was an additional layer in the A1 pulley in pathological cases which was not present in normal pulleys.

Key Words: histopathology • pulley • trigger finger • transmission electron microscope

Journal of Hand Surgery (European Volume), Vol. 32, No. 5, 556-559 (2007)
DOI: 10.1016/J.JHSE.2007.06.002
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