Clinical significance of proximal interphalangeal joint pain in patients with trigger fingers

2018 ◽  
Vol 44 (4) ◽  
pp. 379-384
Author(s):  
Jin Young Kim ◽  
Gook Jin Choi ◽  
Dong Mo Kang
Keyword(s):  
Surgical Outcomes ◽  
Joint Pain ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Trigger Finger ◽  
Symptom Duration ◽  
Pain Group ◽  
Level Of Evidence ◽  
Comparison Of The Results ◽  
A1 Pulley

We investigated incidence, clinical features and surgical outcomes of trigger finger accompanied by proximal interphalangeal joint pain. One-hundred and seventy-nine consecutive patients with trigger finger who had A1 pulley release were recruited. Forty-two patients (24%) complained of proximal interphalangeal joint pain at the time of surgery. Symptom duration was investigated, and tenderness at the proximal interphalangeal joint was palpated. Range of motion and pain score of the affected finger were measured pre- and post-operatively. Bone scan was performed to identify joint lesions. A comparison of the results between the proximal interphalangeal joint pain group and the non-proximal interphalangeal joint pain group shows that the proximal interphalangeal joint pain seemed to result from long symptom duration and consequent joint pathology. The proximal interphalangeal joint pain was incompletely resolved after A1 pulley release. Thus, the surgical outcomes might be worse than expected in spite of resolution of painful clicking, especially when there was additional joint tenderness on palpation. Level of evidence: IV

scholarly journals Comparative study of ultrasonography-guided percutaneous A1 pulley release versus blinded percutaneous A1 pulley release

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901877236 ◽  
Author(s):  
Sung Hyun Lee ◽  
Young Chae Choi ◽  
Hong Je Kang
Keyword(s):  
Patient Satisfaction ◽  
Postoperative Pain ◽  
Prospective Study ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Trigger Finger ◽  
Analog Scale ◽  
Vas Score ◽  
A1 Pulley

Purpose: The purpose of this study was to compare the results of blind versus ultrasonography-guided percutaneous A1 pulley release for treatment of trigger finger. Methods: This prospective study included 21 patients (25 fingers) who underwent blind release and 20 patients (23 fingers) who underwent ultrasonography-guided release. The visual analog scale (VAS) score, proximal interphalangeal joint contracture, complications, and patient satisfaction were compared between the groups. Results: At the final follow-up, triggering had disappeared in all patients who underwent ultrasonography-guided release, whereas three patients who underwent blind release required revision surgery for postoperative triggering. No complications were observed. VAS score was significantly different between groups at 2 and 4 weeks postoperatively. All patients who underwent ultrasonography-guided release were satisfied, whereas three patients who underwent blind release were not satisfied. Conclusion: Ultrasonography-guided percutaneous A1 pulley release for treatment of trigger finger reduces postoperative pain and complications, such as incomplete release, compared with a blind procedure.

Trigger Finger Treatment by Ulnar Superficialis Slip Resection (U.S.S.R.)

2004 ◽  
Vol 29 (4) ◽  
pp. 368-373 ◽  
Author(s):  
D. LE VIET ◽  
I. TSIONOS ◽  
M. BOULOUEDNINE ◽  
D. HANNOUCHE
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Trigger Finger ◽  
Flexion Deformity ◽  
Full Extension ◽  
History Of ◽  
Flexor Digitorum ◽  
Fixed Flexion Deformity ◽  
A1 Pulley

Surgical release of the A1 pulley for treatment of trigger finger normally produces excellent results. However, in patients with long-standing disease, there may be a persistent fixed flexion deformity of the proximal interphalangeal joint. This is sometimes due to a degenerative thickening of the flexor tendons and may be treated by resection of the ulnar slip of flexor digitorum superficialis tendon. One hundred seventy-two patients (228 fingers) who had undergone this procedure were reviewed at a mean follow-up of 66 months. Mean pre-operative fixed flexion deformity of the proximal interphalangeal joint was 33°. All but eight fingers were improved by surgery and there was an average gain of 26° in passive extension (7° residual fixed flexion deformity) of the proximal interphalangeal joint. Full extension was attained in 141 of the 228 fingers, and in all 101 fingers with a pre-operative loss of passive extension of 30° or less. This technique is indicated for patients with loss of passive extension in the proximal interphalangeal joint and a long history of triggering.

Percutaneous A1 Pulley Release Combined with Finger Splint for Trigger Finger with Proximal Interphalangeal Joint Flexion Contracture

2019 ◽  
Vol 24 (03) ◽  
pp. 270-275
Author(s):  
Tzu-Cheng Yang ◽  
Duretti Fufa ◽  
Hui-Kuang Huang ◽  
Yi-Chao Huang ◽  
Ming-Chau Chang ◽  
...  
Keyword(s):  
Flexion Contracture ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Trigger Finger ◽  
Group I ◽  
Percutaneous Release ◽  
Pip Joint ◽  
Joint Flexion ◽  
Group Ii ◽  
A1 Pulley

Background: Long-standing trigger finger can lead to proximal interphalangeal (PIP) joint flexion contracture. In the present study, we present the clinical outcome of percutaneous release with finger splinting for trigger finger with PIP joint flexion contracture prospectively. Methods: We compared outcomes in patients with trigger fingers combined with proximal interphalangeal joint flexion contracture treated by percutaneous release therapy regimen alone (group I) or percutaneous trigger finger release combined with finger splint (group II) during January 2011 and May 2016 with 6 months follow up. Results: Sixty-five patients were randomly allocated to group I (35 patients) or group II (30 patients). Symptoms of locking sensation and pain over the A1 pulley were improved in all patients. The patients in group II showed significantly greater improvements in the flexion contracture angles of proximal interphalangeal joint at post-operative 3 months later (group I, 9.4° ± 4.1°; group II, 27.8° ± 4.6°) and at 6 months later (group I, 15.1° ± 5.2°; group II, 35.7° ± 5.3°) relative to group I. In group II, 25 fingers achieved near full extension (< 10° contracture) after 6 months. Conclusions: Percutaneous release combined with finger splint is regarded as a useful therapy to speed recovery of trigger finger with proximal interphalangeal joint flexion contracture.

A proximal interphalangeal joint custom-made orthosis in trigger finger: Functional outcome

Hand Therapy ◽  
2021 ◽  
pp. 175899832110187
Author(s):  
Kawee Pataradool ◽  
Chayanin Lertmahandpueti
Keyword(s):  
Outcome Measures ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Mean Difference ◽  
Trigger Finger ◽  
Symptom Improvement ◽  
Dash Score ◽  
Full Time ◽  
Custom Made ◽  
Quick Dash

Introduction Trigger finger is a common and functionally limiting disorder. Finger immobilization using an orthotic device is one of the conservative treatment options for treating this condition. The most common orthosis previously described for trigger finger is metacarpophalangeal joint immobilization. There are limited studies describing the effectiveness of proximal interphalangeal joint orthosis for treatment of trigger finger. Methods This study was a single group pretest-posttest design. Adult patients with single digit idiopathic trigger finger were recruited and asked to wear a full-time orthoses for 6 weeks. The pre- and post-outcome measures included Quick-DASH score, the Stages of Stenosing Tenosynovitis (SST), the Visual Analogue Scale (VAS) for pain, the number of triggering events in ten active fists, and participant satisfaction with symptom improvement. Orthotic devices were made with thermoplastic material fabricated with adjustable Velcro tape at dorsal side. All participants were given written handouts on this disease, orthotic care and gliding exercises. Paired t-tests were used to determine changes in outcome measures before and after wearing the orthosis. Results There were 30 participants included in this study. Evaluation after the use of PIP joint orthosis at 6 weeks revealed that there were statistically significant improvements in Quick-DASH score from enrolment (mean difference −29.0 (95%CI −34.5 to −23.4); p < 0.001), SST (mean difference −1.4 (95%CI −1.8 to −1.0); p < 0.001) and VAS (mean difference −3.4 (95%CI −4.3 to −2.5); p < 0.001). There were no serious adverse events and patient satisfaction with the treatment was high. Conclusions Despite our small study size, the use of proximal interphalangeal joint orthosis for 6 weeks resulted in statistically significant improvements in function, pain and triggering, and also high rates of acceptance in patients with isolated idiopathic trigger finger.

scholarly journals Prospective, Multicenter, Clinical and Radiographic Evaluation of a Biointegrative, Fiber-Reinforced Implant for Proximal Interphalangeal Joint Arthrodesis

2020 ◽  
Vol 5 (4) ◽  
pp. 247301142096631
Author(s):  
Luke D. Cicchinelli ◽  
Jurij Štalc ◽  
Martinus Richter ◽  
Stuart Miller
Keyword(s):  
Adverse Events ◽  
Prospective Trial ◽  
Case Series ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Radiographic Evaluation ◽  
Fiber Reinforced ◽  
Level Of Evidence ◽  
Surgery Patient ◽  
Patient Reported

Background: A novel biointegrative implant was developed for proximal interphalangeal joint (PIPJ) arthrodesis to treat hammertoe deformity. Composed of continuous reinforcing mineral fibers bound by bioabsorbable polymer matrix, the implant demonstrated quiescent, gradual degradation with complete elimination at 104 weeks in animal models. This prospective trial assessed the implant’s safety, clinical performance, and fusion rate of PIPJ arthrodesis for hammertoe correction. Methods: Twenty-five patients (mean age 63.9±7.5 years) who required PIPJ arthrodesis were enrolled at 3 centers. Outcomes included radiographic joint fusion, adverse events, pain visual analog scale (VAS) score, Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) score, and patient satisfaction. Patients were evaluated 2, 4, 6, 12, and 26 weeks postoperatively. Results: Twenty-two patients (88%) achieved radiographic fusion at 26 weeks. All joints (100%) were considered clinically stable, with no complications or serious adverse events. Pain VAS improved from 5.3±2.5 preoperatively to 0.5±1.4 at 26 weeks postoperatively. FAAM-ADL total scores and level of functioning improved by mean 19.5±19.0 points and 24.4±15.7 percentage points, respectively, from preoperation to 26 weeks postoperation. Improvements in pain VAS and FAAM scores surpassed established minimal clinically important differences. All patients were very satisfied (84%) or satisfied (16%) with the surgery. Patient-reported postoperative results greatly exceeded (72%), exceeded (20%), or matched (8%) expectations. Conclusion: This prospective, multicenter, first-in-human clinical trial of a novel biointegrative fiber-reinforced implant in PIPJ arthrodesis of hammertoe deformity demonstrated a favorable rate of radiographic fusion at 12 and 26 weeks, with no complications and good patient-reported clinical outcomes. Level of Evidence: Level IV, prospective case series.

Effect of anaesthesia of the palmar digital nerves on proximal interphalangeal joint pain in the horse

2010 ◽  
Vol 36 (5) ◽  
pp. 409-414 ◽  
Author(s):  
J. SCHUMACHER ◽  
L. LIVESEY ◽  
F. J. GRAVES ◽  
J. SCHUMACHER ◽  
M. C. SCHRAMME ◽  
...  
Keyword(s):  
Joint Pain ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint

The hemi-hamate autograft arthroplasty in proximal interphalangeal joint reconstruction: a systematic review

2014 ◽  
Vol 40 (1) ◽  
pp. 24-32 ◽  
Author(s):  
F. S. Frueh ◽  
M. Calcagni ◽  
N. Lindenblatt
Keyword(s):  
Systematic Review ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Fracture Dislocation ◽  
Joint Involvement ◽  
Level Of Evidence ◽  
Systematic Analysis ◽  
Joint Fracture ◽  
Fracture Dislocations

Palmar lip injuries of the proximal interphalangeal joint with dorsal fracture-dislocation are difficult to treat and often require major reconstruction. A systematic review was performed and yielded 177 articles. Thirteen articles on hemi-hamate autograft were included in full-text analysis. Results of 71 cases were summarized. Mean follow-up was 36 months and mean proximal interphalangeal joint range of motion was 77°. Overall complication rate was around 35%. Up to 50% of the patients showed radiographic signs of osteoarthritis. However, few of those patients complained about pain or impaired finger motion. Based on this systematic analysis and review, hemi-hamate autograft can be considered reliable for the reconstruction of acute and chronic proximal interphalangeal joint fracture-dislocations with joint involvement >50%, but longer-term follow-up studies are required to evaluate its outcome, especially regarding the rate of osteoarthritis. Level of Evidence: II

Treatment of unstable proximal interphalangeal joint fractures with hemi-hamate osteochondral autografts

2016 ◽  
Vol 42 (2) ◽  
pp. 188-193 ◽  
Author(s):  
M. Burnier ◽  
T. Awada ◽  
F. Marin Braun ◽  
P. Rostoucher ◽  
M. Ninou ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Articular Surface ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Pinch Strength ◽  
Middle Phalanx ◽  
Level Of Evidence ◽  
Active Flexion ◽  
The Mean

The primary aim of this study was to assess the clinical and radiological results after hemi-hamate resurfacing arthroplasty in patients with acute or chronic unstable fractures of the base of the middle phalanx and to describe technical features that can facilitate the surgical procedure. Hemi-hamate arthroplasties were done in 19 patients (mean age 39 years) with an isolated fracture at the base of the middle phalanx that involved more than 40% of the articular surface. We assessed ten chronic cases (treated >6 weeks after fracture) and nine acute ones (<6 weeks) at a mean of 24 months. Pain scores, QuickDASH scores, grip strengths, range of motion and radiological findings were recorded at follow-up. At follow-up, the mean active flexion at the proximal interphalangeal joint was to 83° with a mean fixed flexion of 17° (active range of motion 66°). The mean active distal interphalangeal motion was 41°. The mean visual analogue scale score was 1.1. The mean QuickDASH score was 11. The mean pinch strength was 82% of the opposite side. Radiographs revealed one partial graft lysis. Level of evidence: IV

Trigger Finger in a Child as a Complication of Interphalangeal Dislocation

1998 ◽  
Vol 23 (4) ◽  
pp. 541-541 ◽  
Author(s):  
R. D. CASE ◽  
I. J. LESLIE
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Trigger Finger ◽  
A2 Pulley

We describe stenosis of the A2 pulley in a 13-month-old infant following a dislocation of a proximal interphalangeal joint, resulting in triggering of the finger.

Long-term results of single-stage reduction surgery for the treatment of macrodactyly

2016 ◽  
Vol 42 (1) ◽  
pp. 45-50 ◽  
Author(s):  
H.-J. Lee ◽  
P.-T. Kim ◽  
S.-J. Lee ◽  
H.-J. Kim ◽  
I.-H. Jeon ◽  
...  
Keyword(s):  
Corrective Osteotomy ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Single Stage ◽  
Long Term Results ◽  
Reduction Procedure ◽  
Level Of Evidence ◽  
Distal Interphalangeal ◽  
The Mean

We report the long-term results of a single-stage reduction procedure for the treatment of macrodactyly. Six patients (eight cases) were included. These patients underwent a single-stage operation that included debulking with resection of the hypertrophied digital nerve and distal interphalangeal joint fusion or corrective osteotomy. Plain radiographs and functional parameters were assessed. Aesthetic improvement was achieved in all patients. The mean ratios of the lengths and circumference differences between the affected digit and the corresponding normal digit on the other hand were 1:1 and 1:1, respectively. The mean range of motion in the proximal interphalangeal joint was 76°. A sensory deficit in the lateral pulp of the distal phalangeal area was observed in three fingers. The Disabilities of the Arm, Shoulder and Hand score ranged from 0 to 9 (mean 4). The long-term results of the single-stage reduction procedure were satisfactory, as demonstrated by the excellent adjustment of the length and acceptable circumference of the affected digits. Level of evidence: IV

Sign in / Sign up

Export Citation Format

Share Document