scholarly journals Trigger Finger Appearing as Gradually Increasing Digital Nerve Disorder after Surgical Treatment

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Hiroyuki Tsuchie ◽  
Tomio Nishi ◽  
Hidekazu Abe ◽  
Masaaki Takeshima ◽  
Yoichi Shimada
Keyword(s):  
Surgical Treatment ◽  
Nerve Injury ◽  
Scar Tissue ◽  
Trigger Finger ◽  
Common Disease ◽  
Digital Nerve ◽  
Flexor Pollicis Longus ◽  
Open Release ◽  
Flexor Pollicis Longus Tendon ◽  
A1 Pulley

Trigger finger is a common disease, and operative treatments are often applied for it. Digital nerve injury is one of the complications of this surgical treatment, and paresthesia and sensory disturbance occur early after the operation. This paper presents a case of trigger finger appearing gradually as increasing digital nerve disorder after surgical treatment. In the second surgery, scar tissue covered the palmar MP joint where the A1 pulley had existed before, and palmar digital neurovascular tissue of the ulnar side was found on the inside of the scar. The ulnar digital nerve showed swelling like a neuroma, and bilateral digital nerves existed nearer to the center of the flexor pollicis longus tendon than normal digital nerves. Even when we operate on trigger finger by open release, we should create an appropriate surgical space for observation and be careful of digital nerve injury.

scholarly journals Percutaneous trigger finger release

2013 ◽  
Vol 1 (1) ◽  
Author(s):  
BK Pandey ◽  
S Sharma ◽  
RR Manandhar ◽  
RL Pradhan ◽  
S Lakhey ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Clinical Evidence ◽  
Steroid Injection ◽  
Flexor Tendon ◽  
Tendon Sheath ◽  
Trigger Finger ◽  
Digital Nerve ◽  
Open Release ◽  
Percutaneous Release ◽  
A1 Pulley

BACKGROUND: Trigger finger is caused by formation of nodule or thickening of A1 pulley by its fibrocartilage metaplasia resulting in entrapment of the flexor tendon. Conservative treatment of this condition consists of NSAIDs, splint immobilization and steroid injection into the tendon sheath. Failure of the conservative treatment is the indication of an open release. Percutaneous release of trigger finger is advised by several authors. The purpose of this prospective study is to evaluate the results of percutaneous release of trigger finger with 18 gauge needle. METHODS: Fifty one patients with 58 trigger digits were treated by percutaneous release using 18 gauge needle under local anaesthesia. Patients were followed up for an average of 12 months. RESULTS: Overall, 97% achieved an excellent or good result. Two digits experienced recurrent symptoms and required an open release. There was no clinical evidence of digital nerve injury or tendon bowstringing. CONCLUSIONS: We recommend this technique as a safe and effective outpatient procedure for releasing trigger finger. DOI: http://dx.doi.org/10.3126/noaj.v1i1.8126 Nepal Orthopaedic Association Journal Vol.1(1) 2010

scholarly journals Trigger Finger? Just Shoot!

2020 ◽  
Vol 11 ◽  
pp. 215013272094334
Author(s):  
Stephen P. Merry ◽  
Jason S. O’Grady ◽  
Christopher L. Boswell
Keyword(s):  
Steroid Injection ◽  
Corticosteroid Injection ◽  
Primary Care Providers ◽  
Trigger Finger ◽  
Care Providers ◽  
Common Condition ◽  
Step Method ◽  
Gradual Improvement ◽  
Open Release ◽  
A1 Pulley

Trigger finger is a common condition usually curable by a safe, simple corticosteroid injection. Trigger finger results from a stenotic A1 pulley that has lost its gliding surface producing friction and nodular change in the tendon. This results in pain and tenderness to palpation of the A1 pulley, progressing to catching and then locking. Splinting for 6 to 9 weeks produces gradual improvement in most patients as does a quick steroid injection with the latter resulting in resolution of pain in days and resolution of catching or locking in a few weeks. Percutaneous or open release should be reserved for injection failures particularly those at high risk for continued injection failure including diabetics and those with multiple trigger fingers. We present a step-by-step method for injection with illustrations to encourage primary care providers to offer this easily performed procedure to their patients.

Complex Irreducible Dorsal Dislocation of Thumb Interphalangeal Joint: Controversies and Consensus in Management

2020 ◽  
Vol 25 (03) ◽  
pp. 378-383
Author(s):  
Leon Alexander
Keyword(s):  
Similar Case ◽  
Case Reports ◽  
Interphalangeal Joint ◽  
Digital Nerve ◽  
Sesamoid Bone ◽  
Flexor Pollicis Longus ◽  
Joint Dislocation ◽  
Comparative Review ◽  
Flexor Pollicis Longus Tendon ◽  
Broad Consensus

Dislocations of thumb interphalangeal (IP) joint are rare injuries due to inherent stability of the joint. This report presents a case of complex irreducible dorsal IP joint dislocation of thumb due to interposition of four structures – volar plate, sesamoid bone, flexor pollicis longus tendon and digital nerve which is perhaps the only case reported so far in literature where more than three structures have been implicated for this joint irreducibility. The author presents a comparative review of similar case reports previously reported in literature listing the controversies in management and forming a broad consensus in the management of these difficult injuries. Finally, an algorithm for the management of these injures has been proposed in this article which maybe helpful for other operators in tackling these injuries so as to deliver predictable treatment outcomes.

scholarly journals Results of percutaneous release of stenosing tenosynovitis (trigger finger) using hypodermic needle

2019 ◽  
Vol 5 (4) ◽  
pp. 578
Author(s):  
Shiv Kumar ◽  
Khalid Muzzafar ◽  
Irfan Tasaduq ◽  
Arpan Bijyal
Keyword(s):  
Hand Function ◽  
Trigger Finger ◽  
Hypodermic Needle ◽  
Common Condition ◽  
Open Release ◽  
Percutaneous Release ◽  
Stenosing Tenosynovitis ◽  
Level Hospital ◽  
A1 Pulley

<p class="abstract"><strong>Background:</strong> Stenosing tenosynovitis or trigger finger is a common condition affecting finger function, which can lead to disability in hand function. Treatment in form of conservative can be helpful in early stages, however later stages and chronic triggering needs release of A1 pulley either by open or percutaneous methods. The aim of this study was to find the results of percutaneous release of trigger finger with 18 guage needle.</p><p class="abstract"><strong>Methods:</strong> 43 digits in 36 patients were enrolled for this prospective study in a district level hospital over a 2 year period. Release was done under local anaesthesia using 18 guage needle percutaneously. Follow up was done upto 6 months. Final scoring was done at 6 months using Quinell’s criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> We had 81.39% (35 out of 43) excellent to good results. 19.61% (8) needed open release. We had no neurovascular injury or infection in our series.</p><p class="abstract"><strong>Conclusions:</strong> Percutaneous release by 18 guage needle is safe and effective treatment for trigger finger without much complication.</p>

Recurrent Diabetic Trigger Finger. Percutaneous or Open Release as Surgical Treatment is More Effective in Long-term Outcomes?

2021 ◽  
pp. 114-122
Author(s):  
G. Kastanis ◽  
A. Pantouvaki ◽  
P. Kapsetakis ◽  
C. Christoforidis ◽  
C. Chaniotakis ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Trigger Finger ◽  
Long Term Outcomes ◽  
Open Release

scholarly journals The Tag Test for Dupuytren's Surgery

Hand ◽  
2009 ◽  
Vol 4 (3) ◽  
pp. 270-271
Author(s):  
C. P. Charalambous ◽  
S. P. Mills ◽  
M. J. Hayton
Keyword(s):  
Surgical Treatment ◽  
Nerve Injury ◽  
Dupuytren’S Disease ◽  
Simple Test ◽  
Digital Nerve ◽  
Dupuytren's Disease

Digital nerve injury is a well-recognised complication of surgical treatment for Dupuytren's disease. We describe a simple test, the Tag test, that can be used intra-operatively to help identification of the digital nerves.

scholarly journals Comparison of impairment and restitution of hand function in a group of patients with total damage to the extensor pollicis longus and in a group of patients with damage to the flexor pollicis longus tendon after surgical treatment

2016 ◽  
Vol 20 (3) ◽  
pp. 5-12
Author(s):  
Jakub Szczechowicz ◽  
Krzysztof Jamka ◽  
Marek Pieniążek
Keyword(s):  
Surgical Treatment ◽  
Physical Therapy ◽  
Muscle Strength ◽  
Hand Function ◽  
Functional Improvement ◽  
Study Group ◽  
Flexor Pollicis Longus ◽  
Extensor Pollicis Longus ◽  
Flexor Pollicis Longus Tendon ◽  
Total Damage

The thumb constitutes 40% of the whole hand function, and damage to the extensor pollicis longus (EPL) and/or the flexor pollicis longus (FPL) tendons of the thumb results in its significant limitation. The main factors contributing to damage of the EPL and/or FPL tendons are mechanical injuries - cuts and spontaneous ruptures. The aim of the study was to compare values of thumb and whole hand function loss and restoration as a result of the implemented physical therapy in patients with total damage to the EPL tendon with the values obtained by the study group 2 comprised of patients with damage to the FPL tendon. The study involved 25 patients of the Specialized Hand Therapy Center in Krakow. 15 of them had ruptured continuity of the EPL tendon (study group), and 10 suffered damage to the FPL tendons (control group). The study included measurements of active motion of the thumb and wrist and superficial sensation. On the basis of these tests, functional impairment was measured using the methodology according to Swanson. The study included assessment of muscle strength in terms of global and precision grips using a dynamometer. Statistically signifcant functional improvement was noted for the thumb and whole hand as well as muscle strength in both groups. The values of functional loss differed between the two groups. The indicators of functional improvement were greater in patients with damage to the EPL tendon. Functional physical therapy is an important factor determining the return of function in the thumb and whole hand after total damage to the EPL and FPL tendons. Szczechowicz J., Jamka K., Pieniążek M. Comparison of impairment and restitution of hand function in a group of patients with total damage to the extensor pollicis longus and in a group of patients with damage to the flexor pollicis longus tendon after surgical treatment. Med Rehabil 2016; 20(3): 5-12. DOI: 10.5604/01.3001.0009.5009

scholarly journals A Cadaveric Study of the Thread Trigger Finger Release: The First Annular Pulley Transection Through Thread Transecting Technique

Hand ◽  
2017 ◽  
Vol 13 (2) ◽  
pp. 170-175 ◽  
Author(s):  
Danqing Guo ◽  
Danzhu Guo ◽  
Joseph Guo ◽  
Logan C. McCool ◽  
Brionn Tonkin
Keyword(s):  
Clinical Study ◽  
Flexor Tendon ◽  
Carpal Tunnel Release ◽  
Cadaveric Study ◽  
Trigger Finger ◽  
Digital Nerve ◽  
Iatrogenic Injuries ◽  
A2 Pulley ◽  
Annular Pulley ◽  
A1 Pulley

Background: After the thread transecting technique was successfully applied for the thread carpal tunnel release, we researched using the same technique in the thread trigger finger release (TTFR). This study was designed to test the operational feasibility of the TTFR on cadavers and verify the limits of division on the first annular (A1) pulley to ensure a complete trigger finger release with minimal iatrogenic injuries. Methods: The procedure of TTFR was performed on 14 fingers and 4 thumbs of 4 unembalmed cadaveric hands. After the procedures, all fingers and thumbs were dissected and visually assessed. Results: All of the digits and thumbs demonstrated a complete A1 pulley release. There was no injury to the neurovascular bundle (radial digital nerve in case of thumb), flexor tendon, or A2 pulley for each case. Conclusions: The cadaveric study showed that the technique of TTFR was safe and effective, and the future clinical study is necessary to verify the findings of this study.

scholarly journals Location and Extent of A1, A2 Release and Its Impact on Tendon Subluxation and Bowstringing—A Cadaveric Study

2019 ◽  
Vol 52 (03) ◽  
pp. 349-354
Author(s):  
Laxminarayan Bhandari ◽  
Alireza Hamidian Jahromi ◽  
Aden Gunnar Miller ◽  
Huey Tien
Keyword(s):  
Surgical Treatment ◽  
Upper Extremity ◽  
Traction Force ◽  
Cadaveric Study ◽  
Trigger Finger ◽  
Flexor Tendons ◽  
Safe Limit ◽  
A2 Pulley ◽  
A1 Pulley

AbstractSurgical treatment of trigger finger involves release of A1 pulley. Some authors have theorized that the loss of A1 pulley can lead to ulnar subluxation of flexor tendons, which can be prevented by release of A1 pulley radially, even in a nonrheumatoid hand. However, there is no evidence in literature to either support or oppose this hypothesis. Occasionally, difficulty is encountered to precisely identify where A1 ends and A2 begins. While incomplete release of A1 can cause relapse of triggering, release of substantial A2 can cause bowstringing. Knowledge of the safe limit of concomitant A2 release is beneficial. The study was conducted in 12 cadaver upper extremity specimens. A1 pulleys of 48 fingers were divided at the radial (24 fingers) or ulnar (24 fingers) attachment. A 20lb traction force was applied on the flexor tendons. Any subluxation or bowstringing was noted. The experiment was repeated following serial release of the A2—initially 25%, followed by 50% and 100%. No bowstringing or subluxation was noted when A1 pulley was opened, either by radial or ulnar incision. The same was true for A1 + 25% A2 release. When A1 + 50% A2 pulley were released, bowstringing was observed in 3/48 fingers. When A1 + 100% of the A2 pulley were released, bowstringing occurred in all cases. The location of incision for release of the A1 pulley has no effect on bowstringing or tendon subluxation. Release of additional 25% of the A2 pulley can be performed safely, which corresponds to the level of palmar digital crease.

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