Upper Extremity Tendinopathies (trigger digits, deQuervains, Lateral epicondylitis)-Upper Extremity Tendinopathies (trigger digits, deQuervains, Lateral epicondylitis) Overview

Upper Extremity Tendinopathies (trigger digits, deQuervains, Lateral epicondylitis) Overview

Pdf Summary

Tendinopathy of the hand and wrist can present as trigger finger or De Quervain's tenosynovitis. Trigger finger is characterized by the tendons not gliding smoothly, leading to locking, catching, or triggering of the affected digit. It commonly affects women and is most often due to issues with the A1 pulley at the palm. Treatment options include splinting and steroid injections, which can be curative for 60-90% of patients. Surgical release may be necessary if conservative therapy is unsuccessful. In contrast, De Quervain's tenosynovitis affects the tendons in the first dorsal compartment of the wrist. It is more common in women and can be caused by repetitive motion, increased fluid volume, inflammatory disease, anatomical variations, or trauma. Diagnosis is based on history and physical exam findings, such as tenderness over the first dorsal compartment and positive provocative maneuvers. Non-operative management includes rest, NSAIDs, splinting, and steroid injections. Surgery is indicated if conservative treatments fail. Complications for both conditions are rare and include stiffness, recurrence, pain, digital nerve injury, infection, and tendon laceration.

Keywords

Tendinopathy

hand

wrist

trigger finger

De Quervain's tenosynovitis

A1 pulley

splinting

steroid injections

surgical release

first dorsal compartment