A Clinical Approach to Diagnosing Trigger Wrist
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ORIGINAL ARTICLE
A Clinical Approach to Diagnosing Trigger Wrist M. Arumugam1 · H. Sallehuddin2 · F. M. N. Rashdeen3 Received: 24 June 2020 / Accepted: 24 August 2020 © Indian Orthopaedics Association 2020
Abstract Background Trigger wrist, a relatively unusual condition, is triggering at the wrist produced by wrist or finger motion. The clinical manifestations and surgical results of trigger wrist with multiple etiologies were evaluated. Methods From October 2008 to December 2012, this study retrospectively reviewed 15 patients diagnosed with trigger wrist. The patients comprised six men and nine women with a mean age of 44.8 years (range 29e86 years). The mean follow-up period was 16.2 months (range 11e30 months). Results The causes of trigger wrist were an anomalous muscle belly of the flexor digitorum superficialis (n Z 5), severe tenosynovitis of the flexor tendon (n Z 4), fibroma around the flexor tendon sheath (n Z 2), a rheumatoid nodule (n Z 1), both anomalous muscle belly and tenosynovitis (n Z 1), a ganglion (n Z 1), and pigmented villonodular synovitis (n Z 1). Mildto-moderate symptoms of median neuropathy without thenar muscle atrophy were present in all patients. Postoperatively, all patients recovered well with the resolution of median nerve symptoms, and the wrist triggering was absent. Conclusions Trigger wrist is a relatively rare condition compared with trigger finger, which is the most common disorder of the hand. To avoid inadequate and ineffective treatment of patients with trigger wrist, careful examination and proper diagnosis are vital. Keywords Trigger wrist · Trigger finger at wrist · Carpal tunnel syndrome
Introduction One of the common causes of a painful clicking finger is trigger finger [1]. This is a common condition often seen at the clinic. While it may seem to be a simple problem, one has to be careful before any surgical intervention not to miss triggering occurring due to pathology at the wrist. Trigger wrist or snapping wrist are two commonly used names that describe a pathology at the wrist that can cause painful clicking or snapping wrist on either wrist or even fingers movement [2]. This will mimic the presentation of trigger finger. The definition of trigger wrist is * M. Arumugam [email protected] 1
Department of Orthopaedic Surgery, Faculty of Medicine and Health Science, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
2
Department of Orthopaedics and Traumatology, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia
3
Department of Orthopaedics and Traumatology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
still controversial. Historically trigger wrist had been first reported by Marti et al. and Eibel et al. and these include cases in which movement of the wrist or fingers leads to triggering of the wrist [3, 4]. However, in 1986, Desai et al. suggested the term trigger wrist should only be applied when the triggering occurred in relation to the wrist movement and not the fingers [5, 6]. This is considered as “true trigger wri
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