Trigger thumb or stenosing flexor tenosynovitis of the thumb is characterized by a narrowing of the flexor tendon sheath. This constriction results in the flexor tendon catching as it attempts to glide smoothly through the relatively stenotic sheath. Trigger thumb or trigger finger is caused by a size mismatch of the diameter between the swollen flexor tendon and its sheath at the level of the metacarpal head. The outcome is a noticeable clicking or popping sensation during attempts at thumb extension. Both the extrinsic flexor pollicis longus (FPL) and intrinsic flexor pollicis brevis (FPB) contribute to the flexion process. The FPL tendon travels within its sheath, passing through the A1, oblique, and A2 pulleys, with the A1 pulley positioned most proximally and the A2 pulley situated most distally. Notably, the A1 pulley overlaps the metacarpal bone, overlapping the metacarpophalangeal joint and the base of the proximal phalanx.Trigger thumb typically results from the thickening of the A1 pulley, leading to pain and reduced functionality. Both adults and children can encounter trigger thumb. Although trigger thumb are predominantly acquired in adults, they are regarded as a rare developmental anomaly in children. Treatment for this condition commences with splinting and physical therapy. Intralesional steroid injections are suitable for patients unresponsive to conservative management. In cases where conservative measures prove insufficient, surgical release of the A1 pulley may be necessary to manage the condition effectively. This activity comprehensively reviews the etiology, diagnosis, evaluation, and management of trigger thumb while highlighting the crucial role of interprofessional healthcare teams in fostering collaboration to deliver well-coordinated care to patients with this condition.
- Provider:StatPearls, LLC
- Activity Link: https://www.statpearls.com/ArticleLibrary/viewarticle/30609
- Start Date: 2023-09-01 05:00:00
- End Date: 2023-09-01 05:00:00
- Credit Details: AMA PRA Category 1 Credit™️: 1.0 hours
Nursing: 1.0 hours
Pharmacy: 1.0 hours - MOC Credit Details: ABS - 1.0 Point; Credit Type(s): Accredited CME (ABS)
ABOS - 1.0 Point; Credit Type(s): Accredited CME (ABOS)
ABPATH - 1.0 Point; Credit Type(s): Lifelong Learning (ABPATH)
ABIM - 1.0 Point; Credit Type(s): Medical Knowledge (ABIM)
ABS - 1.0 Point; Credit Type(s): Self-Assessment (ABS)
ABP - 1.0 Point; Credit Type(s): Lifelong Learning and Self-Assessment (ABP) - Commercial Support: No
- Activity Type: Enduring Material
- CME Finder Type: Online Learning
- Fee to Participate: Variable
- Measured Outcome: Learner Knowledge, Learner/Team Competence
- Provider Ship: Directly Provided
- Registration: Open to all
- Specialty: Endocrinology, Diabetes, and Metabolism, General Orthopaedics, General Pediatrics, Hand Surgery, Internal Medicine, Orthopaedic Sports Medicine, Pediatric Rheumatology, Rheumatology, Soft Tissue & Bone, Surgery of the Hand