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Case 116: Funny finger

This elderly gentleman had presented with symptoms of carpal tunnel syndrome, but had lived happily with this other problem for years.

1. What is the diagnosis?

Trigger finger, left ring finger. The triggering happens with every extension movement, however it is only pronounced every few times in this patient.

2. What are the options for treatment?

Observation, steroid injections, however the definitive treatment for this mechanical problem is open release of the flexor sheath (A1 pulley) where the relative constriction is.

See a picture of the A1 pulley - Wheeless textbook of orthopaedics

wheeless textbook of orthopaedics - trigger finger / tenosynovitis