Severe trigger finger-fibrosis

[Vijitpornkul]

,carrying heavy plastic bags or daily hand function like trimming tree, cutting meat as butcher,these cause over stretch of the A1 pulley and then lose elasticity and turn fibrocartilagenous change get tighten then obstruction of the finger movement cause trigger finger in different severity.I have been doing percutaneous trigger finger release of grade 3-4 severity

[Vijitpornkul]

the cause of the obstruction (we might feel like nodule or lump mass.Actually the tendon never has nodule only the sheath contract and block tendon movement.)or the disproportion of the passage.The problem of trigger finger can be initiated by trauma ,bring about tenosynovitis

and the sheath contract so limit the movement later.The another cause from the repetitive forceful grasping

[USNARox2008]

Ever try injection into the tendon sheath with surgical release of the A1 pulley as second-line treatment? The definitive mechanism of the etiology is still undetermined, but did you consider nodule or pulley morphology change?

[Vijitpornkul]

Injection 0.5-1 cc of 10mg/cc of triamcinolone into tendon sheath is beneficial to fascilitate early movement and more comfortable for the patient.But injection alone will help temporary if the disease progress up to grade 3-4 .Only surgical treatment will treat the cause of the obstruction .