China
Africa
Explore chapters and articles related to this topic
Other Complications of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Signs and symptoms of carpal tunnel syndrome include hand and wrist pain, tingling, numbness, along the path of the median nerve. Sometimes, the entire hand is affected. The patient often wakes up at night with aching or burning pain, numbness, and tingling. Shaking the hand back and forth can relieve the pain and restore normal sensation. Later in the disease course, there may be thenar atrophy, and weakness of thumb opposition and abduction. Dupuytren contracture begins with tender palm nodules usually near the pinky or ring finger that gradually become painless. A superficial cord then forms, contracting the metacarpophalangeal joints and interphalangeal joints, resulting in arching of the hand. There may be fibrous thickening of the dorsum of the proximal interphalangeal joints. With diabetes, there can also be locked trigger fingers, systemic sclerosis, chronic reflex sympathetic dystrophy, and an ulnar claw hand.
Surgery of the Hand
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Norbert Kang, Ben Miranda, Dariush Nikkhah
The diagnosis of triggering is normally easy to make but overt triggering is sometimes absent, and the patient only gives a history of pain on flexion of the digit which may be confused with or concurrent with arthritis. Trigger finger is common in patients over the age of 50 years, patients with diabetes and patients with rheumatoid arthritis. Where overt triggering is absent, but pain is present, the use of steroid injections is particularly efficacious.
Spot diagnosis and pattern recognition
Published in Caroline J Rodgers, Richard Harrington, Helping Hands: An Introduction to Diagnostic Strategy and Clinical Reasoning, 2019
Caroline J Rodgers, Richard Harrington
The HANDGUIDE study was published in 2014 and aimed to provide some consensus guidelines on how trigger finger (among other common hand conditions) should be treated based on the current evidence and the opinion of experts in the field.9 The consensus was that there were broadly four options, which could be placed in a hierarchy: splinting, corticosteroid injections, corticosteroid injections plus splinting, and hand surgery.9 In primary care, corticosteroid injections can be tried, but it is important to remember that the digital nerves can run in close proximity to the A1 pulley so care needs to be taken when injecting.8 Hand surgery involves trigger finger release, which has been quoted as having success rates of 90% – approximately the same as the success rate for corticosteroid injection.8
Successful treatment of acute worsening complex regional pain syndrome in affected dominant right-hand from secondary pathology of new onset third and fourth digit trigger finger
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
After three years of having CRPS symptoms, he developed acute worsening of right-hand pain and was unable to extend the right third and fourth digit. Physical exam revealed the onset of trigger finger of the right third and fourth digit with painful finger extension and loss of finger range of motion. Typically, trigger finger also called stenosing tenosynovitis is caused by hypertrophy of the finger flexor tendon sheath A1 pulley resulting in digit locking in a flexed position [7]. Pain was excruciating and severely worse than the previous baseline CRPS symptoms. The pain was constant in nature, impairing sleep, and causing the patient to become severely depressed with suicidal ideation. Additionally, activities of daily living were becoming increasingly difficult due to the loss of right-hand function.
Upper extremity impairments in type 1 diabetes with long duration; common problems with great impact on daily life
Published in Disability and Rehabilitation, 2019
Kerstin Gutefeldt, Christina A. Hedman, Ingrid S. M. Thyberg, Margareta Bachrach-Lindström, Hans J. Arnqvist, Anna Spångeus
Finger locking, a symptom suggestive of trigger finger, was nearly three-fold more common in patients (31%) than in controls (12%), and the difference was even greater when looking at prior surgery for trigger finger, which was rare in controls with a prevalence of 1%, while 22% of the patients had undergone surgery. Flexed finger (i.e., inability to fully extend the fingers, suggestive of Dupuytren’s contracture and limited joint mobility) was four-fold more common in patients than in controls, i.e., 28% vs. 7%; p < 0.001. The absence of all five upper extremity impairments or previous surgeries was reported by 21% of the patients vs. 56% of the controls (p < 0.001). Eleven % of the patients vs. 2% of the controls who had previously undergone surgery for carpal tunnel syndrome still reported hand paraesthesia in the surgically treated hand. Similarly, 9% of the patients and 0.1% of the controls who were previously surgically treated for trigger finger still experienced problems with finger locking in the same hand.
Conservative treatment for pyogenic flexor tenosynovitis: a single institution experience
Published in Journal of Plastic Surgery and Hand Surgery, 2020
Tal Frenkel Rutenberg, Steven Velkes, Eliezer Sidon, Lior Paz, Jacques Peylan, Shai Shemesh, Sorin Daniel Iordache
Most patients (30), continued follow-up in the hospital clinic for an average period of 30 days. Thirty-nine patients continued community care for an average duration of 61.9 (SD 43.0) months (range: 0.9–160). Two patients were lost to follow-up. Functional outcomes at last follow-up available (the latest physical exam, regardless if performed within hospital or in a community clinic) are described in Table 3. Three patients were eventually treated surgically, as they did not improve following antibiotic treatment. Two patients improved and healed after surgery. In one patient, the infection had spread causing destruction of the pulley system and osteomyelitis (Table 4). An additional patient had a trigger finger which resolved without surgical intervention.