الفهرس 
AIM OF THE WORKOnly 14 pages are availabe for public view
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Abstract
Trigger finger (Stenosing Tenosynovitis) is a commonly encountered
condition in daily orthopedic practice. Several causes of trigger finger have
been proposed, though the precise etiology has not been elucidated
The initial complaint with trigger finger maybe of a painless clicking
with digital manipulation. Further development of the condition can cause the
catching or popping to become painful with both flexion and extension, and
be related as occurring at either the metacarpophalangeal or pip joints.
The classic presentation of popping and locking of a trigger finger is
typically all that is needed for diagnosis, however with acute onset of
symptoms patients may present with pain and swelling over the involved
flexor sheath with avoidance of finger motion .In these case the classic
popping and triggering are not seen and the diagnosis of trigger must be
differentiated from infection or some other traumatic injury.
Initial management of trigger finger is conservative and involves activity
modification, NSAIDS, drugs for pain control, MCP joint immobilization and
corticosteroid injection.
Injection of corticosteroids for the treatment of trigger finger should be
attempted before surgical intervention especially in patients with recent onset
of symptoms and one affected digit with palpable nodule.
Indications for surgical treatment are generally failure of conservative
treatment to resolve pain and symptoms. The timing of surgery is somewhat
controversial. Operative treatment whether by percutaneous or open release is
highly successful and widely regarded as the ultimate treatment for trigger finger.
This study included thirty patients with a total of thirty seven trigger
fingers with persistent symptoms after at least one previous corticosteroid
injection. They were studied to evaluate the results of percutaneous release of
trigger finger.
The youngest patient was 33 years and the oldest was 70 years with a
mean of 51.53 ± 10.673 years. There were 26 females and 4 male in the study,
the female: male ratio was 6.5:1. The duration of symptoms averages from 6
months up to 36 months. The thumb was affected 16 times (41%), the middle
finger 10 times (25.6%), the ring finger 9 times (23%), the index finger 4
times (10.2%) and the little finger was not affected in any patient. There was
multiple finger affection in 7 patients (23.3%) and only one finger affected in
23 patients (76.7%). There were 19 patients without history of systemic
diseases (63.3%) and 11 patients with history of diabetes mellitus (36.7%) in
the study.
All patients were treated by percutaneous release of trigger finger done
under local anesthesia with the palm and affected finger are prepared with
antiseptic solution. After the release an adhesive bandage is applied and the
patients are instructed to use the hand for activities as tolerated and they are
able to remove the dressing themselves the next day. The patients were
followed up for a period of three months.
The overall results at the end of the study were excellent in 26 patients
(86.7%), good in 3 patients (10%) and poor in 1 patients (3.3%). So the
results were satisfactory in 29 patients (96.7%) and unsatisfactory in 1
patients (3.3%).
At the end of the study, percutaneous trigger finger release is safe ,cost
effective method with low complication rate.