Longitudinal versus transverse A1 pulley incision for trigger finger
Incision Decision: A Prospective Randomized Trial Comparing Longitudinal vs. Transverse A1 Pulley Release Outcomes
This trial will test whether a straight (longitudinal) or a crease-based (transverse) skin incision leads to better hand function, less pain, and improved scarring after open A1 pulley release in adults with trigger finger.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 200 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Washington University School of Medicine Academic / other |
| Locations | 2 sites (Chicago, Illinois and 1 other locations) |
| Trial ID | NCT07516652 on ClinicalTrials.gov |
What this trial studies
This is a prospective, multicenter, randomized controlled trial comparing two skin incision techniques for open A1 pulley release in adults with idiopathic trigger finger (excluding the thumb). Participants are randomly assigned to either a longitudinal incision along the finger or a transverse incision in the distal palmar crease, and outcomes are measured using clinical exams and patient-reported metrics. The primary outcome is hand function at six weeks after surgery, with secondary outcomes including pain, scar healing, return to normal activities, and patient satisfaction. Sites include Washington University/Barnes-Jewish Orthopedic Center in St. Louis and The University of Chicago Medicine in Chicago.
Who should consider this trial
Good fit: Adults aged 18 or older with primary trigger finger of a finger (not the thumb) who are indicated for open A1 pulley release and can give informed consent are ideal candidates.
Not a fit: Patients needing revision or who have had previous surgery on the affected finger, those with trigger thumb, or those unable to undergo surgery or follow-up at the study sites are unlikely to benefit from this trial.
Why it matters
Potential benefit: If successful, the preferred incision could improve postoperative hand function, reduce pain and problematic scarring, and speed return to normal activities after trigger finger surgery.
How similar studies have performed: Prior reports are mostly observational or surgeon-preference series with limited randomized data, so a direct randomized comparison of incision type remains relatively untested.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Adult patients (age ≥ 18 years) * Diagnosed with trigger finger (stenosing tenosynovitis) of a finger (excluding the thumb) * Written informed consent obtained Exclusion Criteria: * Revision surgery * Previous surgery on the affected finger * Patients refusing consent
Where this trial is running
Chicago, Illinois and 1 other locations
- The University of Chicago Medicine — Chicago, Illinois, United States (Recruiting)
- Washington University and Barnes-Jewish Orthopedic Center — St Louis, Missouri, United States (Recruiting)
Study contacts
- Principal investigator: Jason Strelzow, MD — Associate Professor, Orthopaedic Surgery Division of Hand and Microsurgery, Washington University in St Louis
- Study coordinator: Nisha N Kale, MD
- Email: kale.n@wustl.edu
- Phone: 314-906-2072
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.