Trigger finger is a common disease particularly in the middle aged women. A very rare case in which an adult man had 10 trigger fingers was experienced. He was treated with local steroid injections in both thumbs, but trigger finger disease has been aggravated in every digit of both hands. We performed an early operative treatment. Three months after the operation, the patient could perform his work without discomfort in his hands and showed normal range of motion in all fingers.
Tenosynovitis/genetics/physiopathology/*surgery ; Male ; Humans ; Hand Deformities, Acquired/genetics/physiopathology/*surgery ; Fingers/physiopathology/*surgery ; Adult

Adolescent ; Adult ; Female ; Finger Injuries ; physiopathology ; surgery ; therapy ; Fingers ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Recovery of Function ; Replantation ; Treatment Outcome

BACKGROUND: Locking of metacarpophalangeal joint (MPJ) of the index finger occurs when volar radial osteophytes of the metacarpal head catch the accessory collateral ligament. We devised a ligament-preserving approach to quickly restore the MPJ motion while protecting the radial collateral ligament. METHODS: We retrospectively reviewed the results of nine patients treated for a locked MPJ of the index finger. In three patients, closed reduction was successful. In six cases, volar radial osteophytes were excised from the metacarpal head using a ligament-preserving technique through a longitudinal incision on the radial side. We analyzed osteophyte shape and height as demonstrated by X-ray and computed tomography (CT). Function was evaluated by examining the range of motion, recurrence, Disabilities of the Arm, Shoulder and Hand (DASH) score, and MPJ stability based on the key pinch strength. One male and eight female patients were followed for an average of 33 months (range, 12 to 65 months); the average age of patients was 41 years (range, 34 to 47 years). The average duration of locking of the MPJ was 23 days (range, 1 to 53 days). RESULTS: The sharp type of osteophytes was identified in six patients and the blunt type of osteophytes was indentified in three patients. The average height of radial osteophytes on the index finger metacarpal was 4.6 +/- 0.4 mm in the axial CT image. At the final follow-up, the average extension limitation decreased from 26degrees (range, 10degrees to 45degrees) to 0degrees, and further flexion increased from 83degrees (range, 80degrees to 90degrees) to 86degrees. There was no recurrent locking after surgery. The DASH score improved from 24.3 to 7.2. Key pinch strength improved from 67.3% to 90.4%. CONCLUSIONS: We obtained satisfactory outcomes in irreducible locking of the MPJ of the index finger by excising volar radial osteophytes of the metacarpal head using a ligament-preserving approach.
Adult ; Collateral Ligaments/*surgery ; Female ; Fingers/physiopathology/*surgery ; Humans ; Male ; Metacarpophalangeal Joint/physiopathology/*surgery ; Middle Aged ; Osteophyte/complications/*surgery ; Range of Motion, Articular ; Retrospective Studies

OBJECTIVETo investigate the causes and operations for entrapment syndrome of posterior interosseous nerve caused by elbow cyst.

METHODSForm March 2005 to March 2012,5 patients with entrapment syndrome of posterior interosseous nerve caused by elbow cyst were treated with surgical excision and neurolysis including 3 males and 2 females with an average age of 50.4 years old ranging from 35 to 60 years old. The course was from 3 to 10 months with an average of 6.3 months. The main clinical symptoms were pain on the outside of the forearm. The extension muscle power of the metacarpophalangeal joints at the fingers and the wrist had decreased. The EMC showed neurogenic damage or nerve conduction slowing down. According to the functional neurological evaluation standard of British Medical Research Institute ,the motion and sensory function after nerve injury was assessed.

RESULTSPatients were followed up for 3 to 15 months with an average of 8.5 months. Wound healing in patients was good after the operations. There were no significant complications. Three patients were excellent (M4S3+) and 2 patients were good (M3S3). The hand joint function of 5 patients recovered well after operation.

CONCLUSIONThe surgical excision and neurolysis for treatment of entrapment syndrome of posterior interosseous nerve caused by elbow ganglions cyst can remove the entrapment syndrome of the posterior interosseous nerve thoroughly ,promote the neurological function recovery. According to the functional evaluation standard ,operations achieved better therapeutic effect.

Adult ; Bone Cysts ; complications ; Elbow ; innervation ; surgery ; Female ; Fingers ; physiopathology ; Humans ; Male ; Middle Aged ; Nerve Compression Syndromes ; etiology ; physiopathology ; surgery ; Wrist ; physiopathology