TRIGGER THUMB

(Syn. Stenozing Tenosynovitis of Flelexor Pollicis Longus Tendon)

Trigger Thumb is a painful clinical condition in which the terminal phalanx if the thumb gets locked in a state of flexion. Sometimes it is bilateral i.e. involving both hands. Big toes of the feet are usually not involved. The condition at some stage may become painless. It is more common in diabetics.

Trigger thumb is caused as a result of inflammation of the tunnel of the thumb in which the (Flelexor Pollicis Longus) tendon moves. As a result the tunnel gets narrowed, usually at the metacarpo phalangeal joint and arrests the gliding movement of the tendon. Sometimes there is a nodule formation in the tendon at the same place producing obstruction to the tendon movement.

Treatment

Non steroid anti inflammatory drugs help in reducing pain and swelling. Physiotherapy helps in regaining movements of the joint. Sometimes in local infiltration with steroids gives relief. However long term effects of steroids are not desirable.

Surgical Treatment if the medical treatment does not succeed, then surgical release of the tendon should be undertaken. It a one stitch surgery which can be done under local anesthesia with constantly good results.

Congenital Trigger Thumb some children are born with it. The congenital variety is usually bilateral. In these cases the treatment is surgical only. It should be done early otherwise the terminal phalanx of the child will not grow and remain small in size.