A young man in his 20s, surnamed Chen, downloaded a mobile game and played it on the cellphone for over 8 hours every day. One week later, he found there was pain and swelling in the metacarpophalangeal joint of his left thumb; the pain was aggravated while bending the thumb, and he couldn’t use the cellphone as usual. After seeking medical care in the outpatient department, he knew he suffered from trigger finger. The left thumb was normal again after continuous treatment and a change in his cellphone use habit. Zhao Hao-yu, attending physician of Orthopedics in the Zhongxiao Branch of Taipei City Hospital, expressed that stenosing tenosynovitis of the finger flexor tendon is often referred to as trigger finger. The repeated stretching, flexing, grabbing and holding of the finger flexor tendons, as well as long-time use and friction lead to the inflammation and thickening of the flexor ligament and the 1st or 2nd annular pulleys, making finger movement difficult. It is more often seen among middle-aged and elderly people, while women have a higher incidence rate than men. Early symptoms of trigger finger are pain and inflammation in the metacarpophalangeal joint and difficulty in flexing and stretching fingers. During the middle stage, the fingers will get stuck just like the trigger while flexing fingers and then pop back after application of force. In the later stage, the symptoms will worsen and the fingers can’t flex or extend by themselves, just remaining rigid in the stretched or flexed position. Dr. Zhao points out that drugs can be taken to diminish inflammation and kill pain in the early stage, and that appropriate rehabilitation and a good rest help the recovery. Local steroid injection is usually required in the middle stage, but excessive injection may cause problems such as tendon rupture, bacterial infection and skin and muscle atrophy. Patients who don’t get better after two successive injections or are in the later stage are advised to receive ligamentolysis, which is a kind of outpatient procedure requiring only local anesthesia. The wound of traditional surgery is about 1 or 2cm wide. Minimally invasive ligamentolysis is another option, which leads to a wound of pin-hole size. The fingers can then move normally without the need of stabilization during recovery. People who frequently use fingers or apply force shall soak their hands in warm water for routine care, stretch fingers backwards and avoid long-time force application and grasping or holding too hard. Those who experience early symptoms are advised to seek examination and treatment in an Orthopedic Clinic immediately to avoid deterioration of trigger fingers.
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