UNASSIGNED: A trigger finger is recognized as the most common hand tendinopathies that reduce functional ability. The present study compares the clinical outcomes of open classic release surgery with ultrasound-guided percutaneous surgery in cases of multiple finger involvement.
UNASSIGNED: A cohort study has been performed from March 2019 to December 2020 by participating 34 trigger finger patients with multiple involvements. These patients were treated using classical open release and ultrasound-guided percutaneous release methods and both methods were compared in patients. The pain severity and functional ability obtained from the quick disabilities of the arm, shoulder, and hand (Quick-DASH) test scores were compared.
UNASSIGNED: The pain intensity in the classical open surgery patients was not significantly different from the ultrasound-guided group, and a one-month follow-up showed that the pain intensity in the ultrasound-guided patients was significantly less than in the other group (P = 0.02). Besides, no significant difference was observed between the functional abilities before and after the one-month follow-up. Indeed, the two groups had the same situations. Also, the recovery time in the ultrasound-guided percutaneous release group was significantly faster than in the other group. These cases had statistical differences as P = 0.001 and P < 0.001, respectively. The surgical release was 100% successful in both groups. The patients\' satisfaction rates in the ultrasound-guided and open classic surgery treatment methods were 94.1 and 76.4%, respectively.
UNASSIGNED: Classical open release and ultrasound-guided percutaneous surgery could successfully treat multiple trigger fingers. However, ultrasound-guided percutaneous surgery provided faster recovery and less pain intensity than the other method.

The differential diagnosis of a trigger finger presents a clinical challenge. This case depicts a 32-year-old male patient who presented with persistent snapping of the right index finger at the metacarpophalangeal joint without localized tenderness despite previous surgical A1-annular ligament release. CT diagnostics demonstrated a prominent articular tuberosity. The MRI showed no pathological findings. Surgical revision with concomitant excision of the tuberosity restored smooth mobility of the index finger.
UNASSIGNED: Die Differenzialdiagnostik des schnellenden Fingers stellt eine klinische Herausforderung dar. Im vorgestellten Fall wird ein 32-jähriger Patient präsentiert, welcher sich mit einem persistierenden Schnappen des rechten Zeigefingers im Metakarpophalangealgelenk ohne lokale Druckschmerzhaftigkeit trotz vorheriger operativer A1-Ringbandspaltung vorstellte. In der CT-Diagnostik konnte ein prominentes Tuberculum articularis nachgewiesen werden. Die MRT-Bildgebung war unauffällig. Durch operative Revision mit begleitender Abtragung des Tuberkulums ließ sich eine volle Funktion des Zeigefingers wieder herstellen.

Hallux saltans is similar to digitus saltans and produces a spontaneous \"snapping\" of the big toe. This results in a constriction of the flexor hallucis longus tendon within the osteofibrous retromalleolar canal. The diagnosis was first described in 1940, and only a few case reports exist. We present the diagnosis and the treatment of a patient and give a review of the literature.
UNASSIGNED: Der Hallux saltans führt, ähnlich wie beim Digitus saltans, zu einem plötzlichen „Schnappen“ der Großzehe. Dabei kommt es zu einer Einengung der Flexor-hallucis-longus-Sehne innerhalb des osteofibrösen Kanals retromalleolär. Die Diagnose wurde erstmals 1940 beschrieben und es existieren nur einzelne Fallberichte. Wir präsentieren die Diagnostik sowie Therapie bei einem Patienten und geben einen Überblick über die Literatur.

Background: The diagnosis of trigger finger (TF) in patients who do not demonstrate triggering at presentation can be challenging. We have been using a new test for TF - the Lenox Independent Flexion Test (LIFT). The aim of this study is to determine the sensitivity of LIFT in diagnosing TF. We hypothesise that LIFT will be more sensitive compared to the classic physical exam finding of triggering or locking with active range of motion (AROM). Methods: This is a prospective study of consecutive patients with TF over a 5-month period. Patients with the onset of trigger following trauma and trigger of the thumb were excluded. Patients were examined for tenderness over the first annular (A1) pulley, triggering or locking with AROM, and the LIFT was performed. A two-proportion test was used to determine whether the LIFT was more sensitive than triggering with AROM. Results: The study included 85 patients with 118 TFs. The average age of patients was 63 years and the study included 49 women. There were 69, 49, 0 and 0 grade I, II, III and IV TF, respectively. 108 fingers (92%) had a history of catching or locking of the affected digit, 110 (93%) had tenderness over the A1 pulley, 49 (44%) had triggering or locking with AROM and 102 (91%) had a positive LIFT. The LIFT was found to be more sensitive when compared to triggering with AROM (p < .001). Conclusion: The LIFT is more sensitive than triggering with AROM in the diagnosis of trigger digits. This test is especially useful in the diagnosis of TF in patients who do not have triggering at presentation. Level of Evidence: Level III (Diagnostic).

A snapping tendon on the dorsal aspect of the thumb is a rare condition as opposed to the common triggering on the volar aspect of the thumb. This condition is known as triggering of the extensor pollicis longus (EPL). A 21-year-old female presented with a clicking or snapping sensation that was felt on the dorsum of her thumb when it is extended. There was no history of trauma. She worked in an ice-cream parlor with repetitive scooping ice-cream motions. Her triggering immediately resolved on releasing the EPL fascia ulnar to Lister\'s tubercle. Upon wake-up surgery, we could immediately confirm this. We recommend dynamic ultrasound as an investigation and do not recommend MRI. The surgical method of choice is either wake-up surgery or wide-awake local anesthesia no tourniquet (WALANT) surgery.

A swan neck deformity (SND) can be well tolerated for a long time, until the appearance of a disabling \"snapping finger\". In its most advanced condition, the other hand is needed to initiate finger flexion. We propose a technique of extra-articular, subcutaneous ligament reconstruction with an \"inverted king post-truss\" configuration use in roofs and to reinforce railway bridges. An artificial ligament (MaxBraid™ polyethylene surgical suture, 5 metric, Biomet) makes a figure of eight between transosseous tunnels in the proximal and middle phalanges, crossing over top of the A3 pulley. We limited our series to severe SND cases with \"snapping finger\". We excluded isolated SNDs without functional disability. Eleven patients were followed for 3.4 years on average. The cause was an acute injury 8 times (7 balloon accidents), rheumatoid arthritis 2 times and overuse once (saxophone). Only one case was a poor outcome of mallet finger. The 11 patients were reassessed by a telephone survey. Two patients underwent reoperation: one for a ligament rupture, the other one for a knot that became untied. One patient had a suspected late rupture but without recurrence of the disabling snapping finger. The 11 patients considered themselves improved by the intervention. Nine patients did not notice any difference between their operated finger and the contralateral side. Return to manual activity was possible once the skin had healed. The technique is simpler than the spiral oblique retinacular ligament (SORL) reconstruction technique described by Thomson-Littler and also less demanding because it does not involve the distal interphalangeal joint. It requires only a short incision in the volar crease of the proximal interphalangeal joint. No tendon or ligament is sacrificed. Neither postoperative immobilization nor lengthy physical therapy is needed. Complications can be avoided by selecting the appropriate artificial ligament material and careful knot tying.