A large fibrotic nodule on the A1 pulley with severe tenosynovitis after repetitive prolotherapy in trigger finger: a case report

Prolotherapy is used to treat chronic musculoskeletal diseases. The efficacy of prolotherapy was recently acknowledged. However, it has not been usually used to treat trigger fingers. Our study was a case report of aggravated flexor tenosynovitis and a fibrous nodule on thickened A1 pulley after repetitive prolotherapy for treating the trigger finger. A 47-year-old electrical engineer complained of a locked and painful triggering in his right ring finger. Preoperative ultrasonography revealed a large hyperechoic mass on the A1 pulley and tenosynovitis. Mass resection and tenosynovectomy were performed. The histological examination revealed a benign fibrous nodule without inflammatory cells. There were no complications at 6 months post-operative, and the patient regained a full range of motion. Reducing inflammation around the flexor tendon and A1 pulley was the most important strategy for the non-surgical management of the trigger finger.