[The operative treatment of a bowstring phenomenon of the thumb in childhood: case report and literature review].

INTRODUCTION

The operative treatment of a congenital trigger thumb comprises splitting the A1 pulley under conditions of hand surgery. One complication is cutting through the A2 pulley. In this case a bowstring phenomenon will result.

CASE REPORT: We report about the reconstruction of the A2 pulley by using a transosseous fixed tendon strip for a now 7-year-old boy with an impressive bowstring phenomenon with profound impairment of thumb function and power after surgery of a trigger thumb at the age of 2 years.

DISCUSSION: The iatrogenic splitting of the A2 pulley during the operative treatment of a congenital trigger thumb and the treatment of the resulting bowstring phenomenon are not sufficiently reflected at the literature. In adulthood, several different methods of pulley reconstruction are described.

CONCLUSION

In our opinion this technique is a safe and easy option to reconstruct the A2 pulley without expensive fibre anchors and enables a broad replacement without compromising extension tendons. Also outdated bowstring phenomenons are sufficiently stabilised. A good hand function with full preservation of finger flexibility and power is ensured as well.