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trigger finger thumbs

Zachary J DeBruine, Jiyuan Ke, Kaleeckal G Harikumar, Xin Gu, Peter Borowsky, Bart O Williams, Wenqing Xu, Laurence J Miller, H Eric Xu, Karsten Melcher
Wnt/β-catenin signaling is activated when extracellular Wnt ligands bind Frizzled (FZD) receptors at the cell membrane. Wnts bind FZD cysteine-rich domains (CRDs) with high affinity through a palmitoylated N-terminal "thumb" and a disulfide-stabilized C-terminal "index finger," yet how these binding events trigger receptor activation and intracellular signaling remains unclear. Here we report the crystal structure of the Frizzled-4 (FZD4) CRD in complex with palmitoleic acid, which reveals a CRD tetramer consisting of two cross-braced CRD dimers...
May 1, 2017: Genes & Development
Angelo V Vasiliadis, Iraklis Itsiopoulos
Trigger finger is a mechanical problem with many etiological factors as possible causes, such as diabetes mellitus, carpal tunnel syndrome and repetitive finger movements. Although it can afflict anyone, it is much commoner in middle-aged women than men and the most commonly involved digit is reported to be the thumb. The diagnosis is mainly based on clinical symptoms during examination and first-line treatment is conservative with splinting and corticosteroid injections. Surgical open release is the "gold standard" of trigger finger treatment because it allows more careful inspection of the surgical area and is highly effective with low complication rates...
June 2017: Journal of Hand Surgery Asian-Pacific Volume
Z Marij, Q Aurangzeb, H R Rizwan, R Haroon, M H Pervaiz
INTRODUCTION: Trigger finger is a common cause of pain and disability of the hand. Percutaneous release results in earlier functional recovery and patient satisfaction. This is a rapid and cost-effective method which saves a surgical procedure and results in better functional outcome. MATERIALS AND METHODS: This is a prospective observational study conducted on fifty-two fingers and thumbs in 52 patients treated from 1st July 2014 till 31st December 2014, in the Orthopaedic Section, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan...
March 2017: Malaysian Orthopaedic Journal
Agnes Z Dardas, James VandenBerg, Tony Shen, Richard H Gelberman, Ryan P Calfee
PURPOSE: To quantify the long-term success of repeat injections for trigger fingers and to identify predictors of treatment outcomes. METHODS: This retrospective case series analyzed 292 repeat corticosteroid injections for trigger fingers administered by hand surgeons at a single tertiary center between January 2010 and January 2013. One hundred eighty-seven patients (64%) were female, 139 patients (48%) had multiple trigger fingers, and 63 patients (22%) were diabetic...
April 2017: Journal of Hand Surgery
Vasileios S Nikolaou, Michael-Alexander Malahias, Maria-Kyriaki Kaseta, Ioannis Sourlas, George C Babis
AIM: To investigate the effectiveness of ultrasound-guided release of the first annular pulley and compare results with the conventional open operative technique. METHODS: In this prospective randomized, single-center, clinical study, 32 patients with trigger finger or trigger thumb, grade II-IV according to Green classification system, were recruited. Two groups were formed; Group A (16 patients) was treated with an ultrasound-guided percutaneous release of the affected A1 pulley under local anesthesia...
February 18, 2017: World Journal of Orthopedics
R Bassani, C Rosazza, L Ghirardin, V Caldiera, E Banco, C Casati, L Tesio
BACKGROUND: Pathologic crying, devoid of any emotional counterpart, is known to occur as a consequence of various brain stem, cortical hemispheric and cerebellar lesions or, quite exceptionally, of "dacrystic" epilepsy. The case reported here suggests that thalamic lesions may also cause crying spells, under the special circumstances described below. CASE PRESENTATION: After a mild left thalamic stroke a caucasian 77 years old man presented with crying spells with no emotional counterpart, triggered by thumb-index rubbing of his right hand...
February 24, 2017: BMC Research Notes
Seng Han Lim, Jian Yao Ng, Lifeng Kang
The hand function of patients who suffer from trigger finger can be impaired by the use of traditional splints. There is also a risk of systemic side effects with oral non-steroidal anti-inflammatory drugs (NSAIDs) used for pain relief. Microneedle-assisted transdermal drug delivery offers an attractive alternative for local delivery of NSAIDs. However, traditional microneedle arrays fabricated on flat surfaces are unable to deliver drugs effectively across the undulating skin surface of affected finger(s)...
January 10, 2017: Biofabrication
G Dautel
Congenital thumb anomalies are common and have a major impact given the specific functional role of the thumb. They may occur alone or as part of a multiple congenital anomaly syndrome. The primary goal of surgical management is to improve or restore pincer grip. In patients with 'congenital' trigger thumb, the A1 pulley must be released if the interphalangeal joint remains in fixed flexion. Thumb duplication is generally managed by reconstruction of the thumb from the predominant (ulnar-based) digit; the accessory (radial-based) digit is excised after collection of its tissue components needed for the reconstruction programme...
December 8, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Hossein Saremi, Elham Hakhamaneshi, Mohamad Ali Seif Rabiei
BACKGROUND: To evaluate safety and efficacy of percutaneous release of trigger finger in multiple digits involvement in comparison with single digit involvement. METHOD: A number of 100 patients (131 fingers) were treated by percutaneous release and divided into two groups: single digit (group A) and multiple digits (group B). They were followed up for one year. Success rate, pain, complications and duration of analgesic use were studied and then compared in both groups...
June 2016: Archives of Bone and Joint Surgery
Minying Zhong, Xiyu Zhang
No abstract text is available yet for this article.
February 2016: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
Ellis Chun Fai Li, Christopher Wai Keung Lai
Touchless environment for image manipulation and X-ray acquisition may enhance the current infection control measure during X-ray examination simply by avoiding any touch on the control panel. The present study is intended at designing and performing a trial experiment on using motion-sensing technology to perform image manipulation and X-ray acquisition function (the activities a radiographer frequently performs during an X-ray examination) under an experimental setup. Based on the author's clinical experience, several gesture commands were designed carefully to complete a single X-ray examination...
July 2016: Radiological Physics and Technology
Don Hoang, Ann C Lin, Anthony Essilfie, Michael Minneti, Stuart Kuschner, Joseph Carey, Alidad Ghiassi
PURPOSE: Trigger finger is the most common entrapment tendinopathy, with a lifetime risk of 2% to 3%. Open surgical release of the flexor tendon sheath is a commonly performed procedure associated with a high rate of success. Despite reported success rates of over 94%, percutaneous trigger finger release (PFTR) remains a controversial procedure because of the risk of iatrogenic digital neurovascular injury. This study aimed to evaluate the safety and efficacy of traditional percutaneous and ultrasound (US)-guided first annular (A1) pulley releases performed on a perfused cadaveric model...
July 2016: Journal of Hand Surgery
Junko Sato, Yoshinori Ishii, Hideo Noguchi
OBJECTIVE: This study aims to compare the morphology of the A1 pulley and flexor tendons in idiopathic trigger finger of digits other than the thumb between in neutral position and in the position with the interphalangeal joints full flexed and with the metacarpophalangeal (MP) joint 0° extended (hook grip position). METHOD: A total of 48 affected digits and 48 contralateral normal digits from 48 patients who initially diagnosed with idiopathic trigger finger were studied sonographically...
2016: Open Orthopaedics Journal
Franck Lapègue, Aymeric André, Olivier Meyrignac, Etienne Pasquier-Bernachot, Pierre Dupré, Céline Brun, Sarah Bakouche, Hélène Chiavassa-Gandois, Nicolas Sans, Marie Faruch
Purpose To evaluate the efficacy of ultrasonographically (US)-guided percutaneous treatment of the trigger finger by releasing the A1 pulley with a 21-gauge needle. Materials and Methods This two-part study was approved by the ethics committee, and written consent was obtained from all patients. The first part consisted of 10 procedures on cadaver digits followed by dissection to analyze the effectiveness of the A1 pulley release and detect any collateral damage to the A2 pulley, interdigital nerves, or underlying flexor tendons...
August 2016: Radiology
K Kalb, D Möllmeier, W Hülsemann
BACKGROUND: Trigger finger in children is a rare condition with relevant differences to the more frequent trigger thumb in children and the very frequent trigger finger in adults. PATIENTS AND METHODS: In a retrospective analysis of children who underwent surgery for trigger fingers in 2 specialised centres, we evaluated 42 children with a total of 63 trigger fingers. Due to persistent triggering after release of the A1 pulley based on intraoperative findings in 12 children with a mean age of 3...
February 2016: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
Jennifer F Waljee, Lin Zhong, Hechuan Hou, Erika Sears, Chad Brummett, Kevin C Chung
BACKGROUND: The misuse of opioid analgesics is a major public health concern, and guidelines regarding postoperative opioid use are sparse. The authors examined the use of opioids following outpatient upper extremity procedures to discern the variation by procedure type and patient factors. METHODS: The authors studied opioid prescriptions among 296,452 adults older than 18 years who underwent carpal tunnel release, trigger finger release, cubital tunnel release, or thumb carpometacarpal arthroplasty from 2009 to 2013 using insurance claims drawn from the Truven Health MarketScan Commercial Claims and Encounters, which encompasses over 100 health plans in the United States...
February 2016: Plastic and Reconstructive Surgery
Juan M Giugale, John R Fowler
Trigger fingers are common tendinopathies representing a stenosing flexor tenosynovitis of the fingers. Adult trigger finger can be treated nonsurgically using activity modification, splinting, and/or corticosteroid injections. Surgical treatment options include percutaneous A1 pulley release and open A1 pulley release. Excision of a slip of the flexor digitorum superficialis is reserved for patients with persistent triggering despite A1 release or patients with persistent flexion contracture. Pediatric trigger thumb is treated with open A1 pulley release...
October 2015: Orthopedic Clinics of North America
Kim R Spekreijse, Guus M Vermeulen, Muhammed A Kedilioglu, Harm P Slijper, Reinier Feitz, Steven E Hovius, Ruud W Selles
PURPOSE: To compare in trapeziometacarpal (TMC) osteoarthritis the effects of trapeziectomy with tendon interposition and ligament reconstruction (LRTI) with or without a bone tunnel after a mean follow-up of 5 years. METHODS: We randomized 79 women (aged 40 years or older) with stage IV TMC osteoarthritis to either trapeziectomy with LRTI using a bone tunnel (Burton-Pellegrini) or a tendon sling arthroplasty (Weilby). Before surgery and at 3 months and 1 year after surgery, patients were evaluated for pain, function, strength, satisfaction, and complications...
November 2015: Journal of Hand Surgery
Rodrigo Roitman Pozzatti, Caio Passos Cordeiro, Julia de Menezes Araujo da Cruz, Gabriel Costa Serrão de Araújo
Leiomyoma is a generally benign tumour and common in the uterine smooth muscle. In some cases, it is found in other parts of the human body. In our study, we report the case of a 61-year-old woman with a painless cystic lesion on the first left thumb associated with trigger finger. The first diagnostic hypotheses were ganglionic cyst and giant cell tumour, however, after surgical excision and histological analysis, it was revealed to be a rare leiomyoma of the hand. We report a clinical case and detailed histopathological study, with 12 high-resolution images stained with: H&E, Smooth Muscle Actin, Desmin, S-100 and CD34...
2015: BMJ Case Reports
Eric Y Chang, Karen C Chen, Christine B Chung
Trigger finger (or trigger thumb), also known as sclerosing tenosynovitis, is a common clinical diagnosis that rarely presents for imaging. Because of this selection bias, many radiologists may not be familiar with the process. Furthermore, patients who do present for imaging frequently have misleading examination indications. To our knowledge, magnetic resonance (MR) imaging findings of trigger thumb have not been previously reported in the literature. In this article, we review the entity of trigger thumb, the anatomy involved, and associated imaging findings, which include flexor pollicis longus tendinosis with a distinct nodule, A1 pulley thickening, and tenosynovitis...
August 2015: Skeletal Radiology
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