Patient was identified in the preoperative holding area and the


 Patient was identified in the preoperative holding area and the correct surgical site was marked. Patient was then brought to the Operating Room where a formal time-out was performed to confirm the correct patient, site, and planned operation. Monitored anesthesia care was provided by the anesthesia team. A well padded tourniquet was placed on the upper arm. Patient was then prepped and draped in the usual sterile fashion. Local anesthetic was then injected superficially over the A 1 pulley of the affected digit. The hand was then exsanguinated and tourniquet inflated. An approximately 1 cm longitudinal incision was at the distal palmer crease over the A 1 pulley of the affected digit. We dissected through skin and subcutaneous tissue, being careful to retract the digital nerves. Tenotomy scissors were then used to carefully spread the underlying tissue and retractors place to expose the A 1 pulley. The A 1 pulley was then released sharply with the 15-blade midline. A tenotomy scissor was then used to complete the release proximally and distally. We then confirmed that there was no evidence of continued trigger. In addition, a Ragnell was used to pull the tendons out of the wound to confirm the complete release of A 1 pulley. The wound was then copiously irrigated and closed with two horizontal mattress 4-0 nylon sutures. Sterile dressing applied. Tourniquet was deflated and patient transferred to recovery room without incident in stable condition 

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