Dupuytren's and Trigger finger

Question 1

What is the initial treatment for trigger finger?

Answer 1

NSAIDs, splinting and activity modification

1-3 injections (go down to bone and inject into pulley and sheath)

Question 2

What structure is at risk during surgical treatment of a trigger thumb?

Answer 2

Radial digital nerve crosses the field

Question 3

What is released during surgical treatment of trigger finger?

Answer 3

A1 pulley, sometimes ulnar slip of FDS

Question 4

When surgically treating a trigger finger in a child, what structure may need to be released in addition to the A-1 pulley?

Answer 4

One or both limbs of FDS

Question 5

What is the dominant cell type in Dupuytren’s disease?

Answer 5

Myofibroblasts

Question 6

What clinical finding is characteristic of involvement of the natatory ligament in Dupuytren’s disease?

Answer 6

Web space contracture

Question 7

What structure is involved in Dupuytren’s that can place the NV bundle at risk during resection?

Answer 7

Spiral cord; is located lateral and deep to the NV bundle

Question 8

What is the only retaining dermal ligament not involved with Dupuytren’s disease?

Answer 8

Cleland’s ligament

Question 9

A patient with Dupuytren’s disease enquires about percutaneous needle fasciotomy and collagenase injections. What is true regarding these two treatment modalities?

Answer 9

Pruritic rash and axillary lymphadenopathy may be observed after collagenase injections but are never seen after percutaneous needle fasciotomy; complications and results are similar; higher recurrence rate of both when compared to total fasciectomy

Question 10

What is the most common complication in the surgical treatment of Dupuytren’s?

Answer 10

Hematoma; can lead to flap necrosis