Trigger finger
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Transcript of Trigger finger
Shima’a Jaffer Al-Amer
211504748
TRIGGER FINGER
Objectives:• Normal anatomy of region• Aetiology• Clinical presentation• Investigations• Treatment• Complications
Normal Anatomy
Flexor digitorum profundus
Flexor digitorum superficialis
Etiology• idiopathic• repetitive finger movements • local trauma • stress • degenerative force • occupations requiring extensive gripping and hand flexion
Clinical presentationHistory:
• Initially painless clicking, catching, or locking • painful episodes in which the patient has difficulty spontaneously extending the affected digits.• awaken with the finger locked in the palm, with gradual "unlocking" as the day progresses.• the finger may become locked in flexion requiring passive manipulation of the finger into extension, which can be painful
Clinical presentationPhysical examination• tenderness to palpation over A1 pulley• tender nodule• asked the patient to fully open and close the hand
locking or clicking • Pain may be aggravated by stretching the tendon
in extension
Investigations• injection of lidocaine into the flexor sheath relieve the pain + allow the digit to become actively or passively extended. • no role for imaging • x-rays considered unnecessary in patients without history of inflammatory disease or trauma
TreatmentNonoperative•night splinting, • activity modification,• NSAIDS• steroid injections
TreatmentOperative• surgical debridement and release of the A-1 pulley
• release of A1 pulley and 1 slip of FDS (usually ulnar slip)
Complications• Joint flexion contructure• Radial digital nerve injury• During the dissection, the radial digital nerve crosses the operative field and is at risk.
References• Al Hasan Makkouk, et.al; Trigger finger: etiology, evaluation, and treatment; 2007
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684207/
• UpToDate
http://www.uptodate.com/contents/trigger-finger-stenosing-flexor-tenosynovitis
• Orthobullet
http://www.orthobullets.com/hand/6027/trigger-finger