What Is Surgery - Trigger Finger
Trigger Finger
Trigger finger may present with stiff digit and pain on the distal part of the palm which may radiating along the digit.
Trigger finger is associated with diabetes, rheumatoid arthritis, de Quervain’s thyroiditis, amyloidosis, renal failure, hypothyroidism and carpal tunnel syndrome.
Trigger finger common in children 8 years and below as well as middle age and elderly people.
Trigger finger can be classified based on the Green’s classification. Grade 1 of the Green’s classification indicates pain and tenderness at the A1 pulley, Grade 2 of the Green’s classification indicates catching of the digit, Grade 3 of the Green’s classification indicates the locking of the digit which is passively correctable while Grade 4 of the Green’s classification indicates fixed locked digit.
The pathology of trigger finger is associated with inflammation of the deep flexor tendon and superficial flexor tendon adjacent to the A1 pulley at the metacarpal head. This will inhibit the flexor tendon gliding movement.
The ring finger is commonly affected which is followed by thumb, middle fingers and index finger as well as little fingers.
Patient may present with locking or catching of the digit while in active flexion and extension. Locking in flexion is associated with inability of the extensor to counteract the blocking compare with the flexors.
On examination, there will be locking of the digit as the digit is moved through a range of movement which can be corrected passively.
If patient flexes and extend the digit the flexor tendon will cause a painful click.
Patient may also present with palpable crepitus or snapping over the pulley.
Generally there will be fixed flexion contractures at the proximal interphalangeal joint of the finger and the interphalangeal joint of the thumb.
Nodular enlargement may of the distal tendon may occur as a result of inflammation.
Patient with trigger finger is treated with splinting or medication intake such as NSAIDS or steroid injections.
Surgical treatment of trigger finger will focus on open release procedure where the A1 pulley is exposed through the incision of the palmar and the pulley is divided.
Open release procedure carries its own complications such as infection, transection of the nerve, stiffness, reflex sympathetic, flexor tendon bowstringing, deformity of flexion and recurrence of the incidence of trigger finger.
Trigger finger may present with stiff digit and pain on the distal part of the palm which may radiating along the digit.
Trigger finger is associated with diabetes, rheumatoid arthritis, de Quervain’s thyroiditis, amyloidosis, renal failure, hypothyroidism and carpal tunnel syndrome.
Trigger finger common in children 8 years and below as well as middle age and elderly people.
Trigger finger can be classified based on the Green’s classification. Grade 1 of the Green’s classification indicates pain and tenderness at the A1 pulley, Grade 2 of the Green’s classification indicates catching of the digit, Grade 3 of the Green’s classification indicates the locking of the digit which is passively correctable while Grade 4 of the Green’s classification indicates fixed locked digit.
The pathology of trigger finger is associated with inflammation of the deep flexor tendon and superficial flexor tendon adjacent to the A1 pulley at the metacarpal head. This will inhibit the flexor tendon gliding movement.
The ring finger is commonly affected which is followed by thumb, middle fingers and index finger as well as little fingers.
Patient may present with locking or catching of the digit while in active flexion and extension. Locking in flexion is associated with inability of the extensor to counteract the blocking compare with the flexors.
On examination, there will be locking of the digit as the digit is moved through a range of movement which can be corrected passively.
If patient flexes and extend the digit the flexor tendon will cause a painful click.
Patient may also present with palpable crepitus or snapping over the pulley.
Generally there will be fixed flexion contractures at the proximal interphalangeal joint of the finger and the interphalangeal joint of the thumb.
Nodular enlargement may of the distal tendon may occur as a result of inflammation.
Patient with trigger finger is treated with splinting or medication intake such as NSAIDS or steroid injections.
Surgical treatment of trigger finger will focus on open release procedure where the A1 pulley is exposed through the incision of the palmar and the pulley is divided.
Open release procedure carries its own complications such as infection, transection of the nerve, stiffness, reflex sympathetic, flexor tendon bowstringing, deformity of flexion and recurrence of the incidence of trigger finger.
Trigger finger in this picture is presented as flexion of the ring finger.
