The human hand is an intricate instrument that is both tough and delicate. Its functions of sensation and motion allow us to experience and control the world around us.
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This is a disorder of thickened ligament in the palm, resulting in nodules on the ligament; which if severe enough can cause an inability to fully straighten the fingers. The ring and small fingers are most commonly affected.
The cause of this disorder is unknown. It is seen more commonly in men and is usually found in individuals of Northern European extraction.
If deformity is mild and there is no functional loss, no surgery is needed. If, however, there is significant contracture that interferes with full use of the hand, surgical removal of a portion of the ligament is the treatment of choice to improve function and to prevent further deformity.
Tendonitis on the thumb side of the wrist can be a very painful and disabling condition. Simple pinching and twisting activities can almost be impossible. The tendons to the thumb become inflamed as they pass under a ligament and the slightest motion of the wrist can cause pain.
Treatment consists of rest, medication and occasionally the use of a steroid injection. If these treatments do not provide relief over time, the tendons can be surgically released.
Carpal tunnel syndrome is a common hand problem resulting from pressure on the median nerve at the wrist. Symptoms, which often get worse at night, consist of numbness and/or pain in the wrist and fingers. Eventually there is loss of strength, fine motor control, and sensation.
Early treatment consists of splinting and anti-inflammatory medication. If symptoms do not improve, an outpatient surgical procedure to relieve the pressure on the nerve is suggested.
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Wrist is also called as carpus, a complex joint comprised of bones and joints, ligaments and tendons, nerves, blood vessels, and muscles that hold the bones together.
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Trigger Finger, also known as stenosing tenosynovitis or flexor tendonitis, is a condition where one of the fingers or thumb of the hand is caught in a bent position. The affected digit may straighten with a quick snap, similar to pulling and releasing the trigger on a gun, hence the name trigger finger.
Commonly reported symptoms associated with trigger finger include the following:-
Causes
Trigger finger is caused by inflammation of the tenosynovium. The tenosynovium is the substance that lines the protective sheath around the tendon in the finger. This substance enables the tendon to glide smoothly within the sheath when the finger is bent or straightened. When inflammation is present, the tendon is unable to glide smoothly within its sheath causing "catching" of the finger in a bent position and then suddenly releasing the finger straight. Causes of trigger finger can include the following:
Repetitive Motion: Individuals who perform heavy, repetitive hand and wrist movements with prolonged gripping at work or play are believed to be at high risk for developing trigger finger.
Medical Conditions: Conditions associated with developing trigger finger include hypothyroidism, rheumatoid arthritis, diabetes, and certain infections such as TB.
Gender: Trigger finger is more common in females than males.
Diagnosis
Hand and wrist conditions should be evaluated by an orthopedic hand surgeon for proper diagnosis and treatment. Trigger finger is diagnosed based on the medical history and physical examination and without any special testing required.
Conservative Treatment Options
Your surgeon will recommend conservative treatment options to treat the trigger finger symptoms. Treatment options will vary depending on the severity of the condition.
Conservative treatment options may include the following:
If conservative treatment options fail to resolve the condition and symptoms persist for 6 months or more and your quality of life is adversely affected, your surgeon may recommend you undergo a percutaneous trigger finger release surgical procedure to release the tendon. This surgery is usually performed in an operating room under local or regional anesthesia on an outpatient basis as day surgery. Your surgeon makes one small incision, about inch long, to the affected finger area. The surgeon then releases the tight portion of the flexor tendon sheath. The incision is then closed with a couple sutures and covered with a sterile dressing.
After surgery your surgeon will give you guidelines to follow. Common postoperative guidelines include:
Risks and Complications
As with any major surgery there are potential risks involved. The majority of patients suffer no complications following trigger finger surgery; however, complications can occur and include:
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