16. October 2015 · Comments Off on Trigger Finger · Categories: Finger Injuries

Trigger finger , the more common name for stenosing tenosynovitis, is a rather annoying hand condition in which a finger “locks” in a flexed position and becomes very difficult to bend or straighten.

This condition usually occurs when the pulley thickens at the base of the finger thereby narrowing the canal thorough which the flexor tendons glide. The resistance to gliding causes pain as well as a feeling of popping or catching. The repetitive catching of the tendon causes irritation of the flexor tendons and swelling of the pulley.

Etiology

The cause of trigger finger is often unclear. The condition is sometimes associated with rheumatoid arthritis, gout or diabetes. Often, the first sign is discomfort or tenderness in the region opposite the knuckle at the base of the digit. Later, a nodule may form in this area.

Diagnosis

Diagnosis in rather straight forward without the need for elaborate test. It is based on a simple physical examination of the fingers. The patient will open and close the hand while checking for pain and observing for unrestricted motion.

Treatment

Treatment focuses on alleviating the triggering and achieving painful and unrestricted range of motion. A decrease in swelling will facilitate gliding of the tendons. Oral anti-inflammatory drugs, splintage and/or modifying activities that exacerbate the condition provide conservative measures. In other cases, steroid injection in the region of the pulley may decrease the swelling and alleviate symptoms. As a last resort, surgery is performed in which the A1 pulley in the finger, opposite the knuckle, is released allowing unrestricted motion of the tendons. Relief often occurs immediately after the procedure.

25. September 2015 · Comments Off on Crush Injuries to the Fingertip · Categories: Finger Injuries

About Crush Injuries to the Fingertip

While crush injuries to the fingertip are very common and often appear insignificant, they can cause serious disability to the patient if inappropriately or inadequately treated. These injuries occur when someone accidentally has a door slammed on his or her finger, their finger gets caught in a car door, something heavy falls on the finger, or the fingertips are accidentally caught in a snow blower or lawnmower. Often, these fingertips can be very painful prohibiting useful function not only of the finger but of the entire hand. Inadequate padding over the bony distal phalanx can result in a very painful fingertip. Neuromas, composed of bundles of nerve tissue, can form at the ends of the injured nerves causing sever pain and disability. Additionally, inappropriate care of the nail bed structures can result in nail growth abnormalities, hangnail or an exquisitely painful fingertip.

Treatment for Crush Injuries to the Fingertip

There are various non-surgical and surgical procedures that can be performed to minimize the disability following crush injuries to the fingertip, allowing patients to return to work much soon. Furthermore, the non-injured hand is cared for during this time to prevent problems with stiffness from disuse.

The occupational therapist has several modalities to work with the patient having a painful fingertip. The hand surgeon also has various options to restore useful function to the injured finger. While seemingly minor, compared to more extensive injuries involving multiple structures, they still require appropriate care from an experienced hand surgeon.

At The Chicago Institute for Hand Surgery & Rehabilitation, Dr. Norman Weinzweig has treated hundreds of similar injuries with excellent clinical and aesthetic results, allowing patients to get back to the workplace or to their recreational activities as soon as possible.