Available online 17 November 2023

We report a rare case of flexor tenosynovial fistula secondary to endoscopic release of the A1 pulley for treatment of trigger finger.

A 72-year-old woman underwent endoscopic release of the A1 pulleys of her left ring and right middle fingers. Nine days after surgery, the wound at the base of the proximal phalanx of the ring finger (distal portal) remained open and a clear liquid discharge was seen. The volume of discharge increased with active finger motion. However, there was no evidence of infection. The patient was diagnosed with tenosynovial fistula as a complication of endoscopic release of the A1 pulley. At day 30, the fistula and drainage persisted and the condition was managed by surgical excision of the fistula and primary closure. The wound then healed completely.

Our report alerts hand surgeons to the potential development of flexor tenosynovial fistula as a very rare complication following endoscopic release of the A1 pulley for the treatment of trigger finger.

© 2023 SFCM. Published by Elsevier Masson SAS. All rights reserved.