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| Adult Acquired Flatfoot Deformity (18:00) Clifford Jeng, MD Mercy Medical Center Institute for Foot and Ankle Reconstruction Baltimore, Maryland Achilles Tendon Ruptures (18:20) Clifford Jeng, MD Mercy Medical Center Institute for Foot and Ankle Reconstruction Baltimore, Maryland Pares de Fricción polietilenos (Polyethylene Bearing) [Spanish] (23:07) Enrique Gomez Barrena Cirugia Orthopedica y Traumatologia Universidad Autonoma de Madrid Madrid, Spain La magnitud de las fracturas de cadera (The Magnitude of Hip Fractures) [Spanish] (9:11) Pedro Carpintero-Benitez Department of Orthopedics University Hospital Reina Sofia Cordoba, Spain Artroplastias en las displasias y en las luxaciones de cadera (Arthoplasty in Dysplasia and Dislocation) [Spanish] (29:37) Miguel Cabanela Mayo Clinic Rochester Department of Orthopedic Surgery Rochester, MN Tritanio (Porous metals in Reconstructive Surgery) [Spanish] (25:16) Miguel Cabanela Mayo Clinic Rochester Department of Orthopedic Surgery Rochester, MN THR Ceramics on Ceramics [Spanish] (15:00) Prof. Enrique Guerado, MD Director, Department Of Orthopaedic Surgery and Traumatology Hospital Costa del Sol University of Málaga Selecciín de pacientes en las prítesis de recubrimiento [Spanish] (15:40) Dr. Xavier Gallart Hospital Clinico de Barcelona Fractures of the Pelvic Ring by Anteroposterior Mechanism (13:46) Dr. Placido Zamora-Navas Associate Professor Department of Surgery Trauma Surgeon Virgen de la Victoria University Hospital Malaga, Spain Anatomy of the Pelvis and Acetabulum (17:07) Dr. Placido Zamora-Navas Associate Professor Department of Surgery Trauma Surgeon Virgen de la Victoria University Hospital Malaga, Spain Complication of the Surgical Treatment of the Fracture of the Acetabulum (18:03) Dr. Placido Zamora-Navas Associate Professor Department of Surgery Trauma Surgeon Virgen de la Victoria University Hospital Malaga, Spain Modular Implants for Hip Replacement Revision [Spanish] (15:48) Dr. Jorge Ballester Hospital La Esperanza Barcelona, Spain Osteoporotic Fractures (13:21) Professor Rajesh Malhotra, MBBS, MS Department of Orthopedics All India Institute of Medical Sciences New Delhi, India Trauma Scoring Systems (13:39) Phil Grieve, MB, BCH, BAO, MRCSED Year 4 Specialist Registrar/Senior Resident London, England Heel pain (10:04) Clifford Jeng, MD Mercy Medical Center Institute for Foot and Ankle Reconstruction Baltimore, Maryland Gender concerns in total knee replacement (8:47) Kirby D. Hitt, MD Head of Adult Reconstruction & Joint Replacement Surgery Scott and White Hospital Temple, Texas Tarsal Tunnel Syndrome (11:29) Clifford Jeng, MD Mercy Medical Center Institute for Foot and Ankle Reconstruction Baltimore, Maryland Improving clinical recognition of the Marfan syndrome (8:10) Paul D. Sponseller, MD Professor and Head of the Division of Pediatric Orthopedics The Johns Hopkins Hospital Baltimore, Maryland Orthopedic Hyperguide Introduction (2:18) Rainer Kotz, MD Allgemeines Krankenhaus Wien Meizinische Universität Wien Dept. of Orthopaedics Wien, Austria Use of Botulinum Toxin to Prevent and Treat Post-traumatic Elbow Contractures (14:11) Melvin P. Rosenwasser, MD Professor of Orthopedic Surgery, Robert E. Carroll Professor of Hand Surgery Columbia University College of Physicians and Surgeons New York, New York Rheumatoid Arthritis of the Elbow (36:26) Charles Sorbie MB, ChB Professor of Surgery Queen’s University Kingston, Ontario, Canada General Thoughts on Subcapital Fractures of the Hip (18:21) Charles Sorbie MB, ChB Professor of Surgery Queen’s University Kingston, Ontario, Canada Compartment syndromes: Update & review (8:48) Frank J. Frassica, MD Chairman, Department of Orthopedic Surgery Chief, Adult Division and Musculoskeletal Oncology The Johns Hopkins Hospital Baltimore, Maryland Predicting fracture through benign skeletal lesions with quantitative computed tomography (4:16) Frank J. Frassica, MD Chairman, Department of Orthopedic Surgery Chief, Adult Division and Musculoskeletal Oncology The Johns Hopkins Hospital Baltimore, Maryland |
| Trigger finger | |
| Classification and external resources | |
| ICD-10 | M65.3 |
|---|---|
| ICD-9 | 727.03 |
| eMedicine | orthoped/570 |
Trigger finger, or trigger thumb, is a type of stenosing tenosynovitis (specifically digital tenovaginitis stenosans) in which the sheath around a tendon in a thumb or finger becomes swollen, or a nodule forms on the tendon. Affected digits may become painful to straighten once bent, and may make a soft crackling sound when moved. The label of trigger finger is used because when the finger unlocks, it pops back suddenly, as if releasing a trigger on a gun.
More than one finger may be affected at a time, though it usually affects the thumb, middle, or ring finger. The triggering is usually more pronounced in the morning, or while gripping an object firmly.
Trigger finger is usually idiopathic, meaning that the cause is unknown. Some speculate that repetitive forceful use of a digit leads to narrowing of the fibrous digital sheath in which it runs, but there is no data to support this theory and it may unfairly stigmatize hand use. The relationship of trigger finger to work activities is debatable and scientific evidence for[1] and against[2] hand use as an etiological factor are sparse and of low quality.
There is some evidence that idiopathic trigger finger behaves differently in patients with diabetes.[3]
Contents[hide] |
The natural history of disease for trigger finger remains uncertain.
Injection of the tendon sheath with a corticosteroid is effective over weeks to months in more than half of patients.[4]
The problem is predictably resolved by a relatively simple surgical procedure (usually outpatient, under local anesthesia). The surgeon will cut the sheath that is restricting the tendon.
Investigative treatment options with limited scientific support include: non-steroidal anti-inflammatory drugs, occupational or physical therapy, steroid iontophoresis treatment, splinting, therapeutic ultrasound, phonophoresis (ultrasound with an anti-inflammatory dexamethasone cream), and Acupuncture.
Recurrent triggering is unusual after successful injection and rare after successful surgery.
Difficulty extending the proximal interphalangeal joint may persist for months and benefits from exercises to stretch the finger straighter.
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