| This 11 year old boy developed clicking and locking of his index finger after a chemical (hydrofluoric acid) burn of the finger at the proximal phalanx level. This is an unusual situation in several respects. Locking flexor tendinitis is most common in adults, spontaneous, and involves the tendon in the distal palm. Triggering due to trauma is unusual in children and most pediatric trigger digits involve the thumb. |
| Click on each image for a larger picture |
| Burn scar just proximal to the PIP flexion crease. |
 |
| Visible palmar prominence at this level, firm to palpation. |
 |
| Posture just before clicking... |
 |
| And click. This is his maximum PIP/DIP flexion. |
 |
| At exploration, he was found to have a large rectangular nodule of the profundus tendon, seen here bulging through an area of attenuated tendon sheath. |
 |
| This was accessed through a window in the distal A2 pulley. The tendon nodule was rectangular and very well defined. |
 |
| Tendon reduction, excising lenticular shaped wedges from each side of the tendon to remove the "corners" of the nodule. |
 |
| Sheath closed. |
 |
| Three months postop. |
 |
 |
| No clicking, no bowstringing, full range of motion. |
 |
| Search for...
traumatic trigger finger pediatric trigger finger |
Case Examples Index Page | e-Hand Home |