Trigger finger

Trigger finger (endovaginitis stenosans) is a common source of pain and dysfunction of a finger. t is a condition in which one of your fingers gets stuck in a bent position due to inflammation that narrows the space within the sheath that surrounds the tendon in the affected finger. Your finger may bend or straighten with a snap — like a trigger being pulled (jumping finger) and released. If trigger finger is severe, your finger may become locked in a bent position. It usually affects IV., III. finger and thumb. The condition is common in middle aged women more than men and also diabetic, revmatic and dialyzed patients are in greater risk.

Clinical presentation
The patient comes with peeling (tendon skipping) or finger blockage during flexion or extension. In the initial stages, there is pain when reaching full flexion + crepitation, later "finger snapping". Although the patient often locates difficulties in the interphalangeal joint, palpation sensitivity and skipping (movement of the thickened tendon) is on the palm above the A1 pulley.

Symptoms
Patient comes with snapping („jumping tendon") or blockage while the finger is flexed or extended. In the early stages the condition the finger is painful while fully extended. Despite the patient localizing the pain near the interphalangeal joint palpation sensitivity and jumping is localized more proximaly.

Therapy
First method is conservative approach. That means we let the trigger finger disappear. Second possibility is to stretch the finger a put extention split on for a night. Next method is injection of corticoids with local anesthetic. Last option is surgery. This is only used when all listed above is unsuccessful. During the surgery the tendon's sheat is opened so the tendon of the flexor can move freely.

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