Correction to: A Clinical Approach to Diagnosing Trigger Wrist.

[This corrects the article DOI: 10.1007/s43465-020-00248-7.].

A Clinical Approach to Diagnosing Trigger Wrist.

BACKGROUND: Trigger wrist is a relatively unusual condition, produced by wrist or finger motion. The various causes of trigger wrist can originate from flexor tendon, extensor tendon, bones, or tumour. A proper clinical approach is required to diagnose and manage patients with trigger wrist. METHODS: A keyword search was performed across Google Scholar and PubMed. Articles describing trigger wrist conditions were analysed. Based on the information obtain from the articles, the clinical manifestations and approach to diagnosing the cause of trigger wrist is discussed. RESULTS: A detailed history alone may lead to a reasonably accurate diagnosis. Patients can present with trigger wrist occurring during movement of the fingers or with wrist movements. Presence of tenderness around A1 pulley suggest trigger finger. Absence of tenderness over the A1 pulley may suggest trigger wrist. The wrist should be examined for any swelling or malunion around the wrist joint. Palpate for any bony prominence, clicking, or crepitus with the movement of the wrist. Examination for the presence of carpal tunnel syndrome should be performed. A simple radiograph of the wrist joint is needed to see any possible bony pathology such as malunion, instability or arthritis of the carpal bone. For soft tissue assessment ultrasound would be a good choice and can be done during finger or wrist movement. MRI is useful for further assessment of space occupying lesion within the carpal tunnel and is useful for surgical planning. Nerve conduction study is indicated for patients with median nerve compression symptoms. During the initial stage, the patient should be advised for activity modification to reduce the wrist and finger movements. Surgical treatment will depend on the causative factor. Surgery done under local anaesthesia has the advantage of reconfirming with the patient, resolution of triggering during surgery by asking the patient to actively move the fingers or wrist. 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.

Outcome of Tendon Transfers for Radial Nerve Palsy in a Malaysian Tertiary Centre.

Tendon transfers for radial nerve palsy is a common operation with good results. We did a retrospective study on twenty patients with radial nerve palsy who underwent tendon transfer surgery and recovered between January 2008 and December 2012. Outcomes measured were motor power of wrist extension, finger extension, grip strength and DASH scores. There was significant improvement of motor power of wrist and finger extension between the preoperative period and three months post-operatively, between the pre operative period and six months post operatively and between three and six months postoperatively (p = 0.0005). Grip strength improved significantly as well between preoperative, three and six months postoperatively (p = 0.0005). DASH scores reflecting patient satisfaction at six months postoperatively showed only mild or moderate difficulty of function.

Outcome of Tendon Transfers for Radial Nerve Palsy in a Malaysian Tertiary Centre

@#Tendon transfers for radial nerve palsy is a common operation with good results. We did a retrospective study on twenty patients with radial nerve palsy who underwent tendon transfer surgery and recovered between January 2008 and December 2012. Outcomes measured were motor power of wrist extension, finger extension, grip strength and DASH scores. There was significant improvement of motor power of wrist and finger extension between the preoperative period and three months post-operatively, between the pre operative period and six months post operatively and between three and six months postoperatively (p = 0.0005). Grip strength improved significantly as well between preoperative, three and six months postoperatively (p = 0.0005). DASH scores reflecting patient satisfaction at six months postoperatively showed only mild or moderate difficulty of function.

Ganglion of the Flexor Tendon Sheath at the A2 Pulley - Case Report.

There are few reported cases of flexor tendon sheath ganglion arising from the A2 pulley. We report a case of a flexor tendon sheath ganglion in a 17-year old female who presented with pain, triggering and a swelling at the base of her right ring finger. During the excision biopsy, a ganglion measuring 0.5×0.8×0.4 cm in size was removed from the A2 pulley area.

Simultaneous dislocation of the metacarpophalangeal and subluxation of the carpometacarpal joints of the thumb in a child.

Double dislocations of joints of the thumb are uncommon injuries. We report an unusual case of simultaneous dislocation of the metacarpophalangeal (MCP) and subluxation of the carpometacarpal (CMC) joints of the thumb in a child to illustrate problems related to their treatment.