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A Standardized Acupotomy Protocol For The Treatment of Tenosynovitis of Hand Flexor Tendons In Human Patients

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Pediatric trigger finger from calcific tendonitis.

Uel Hansen¹, Vincent Battista

¹William Beaumont Army Medical Center, El Paso, TX, USA. uel.hansen@amedd.army.mil

The Journal of Hand Surgery

|December 12, 2007

Summary

Triggering of pediatric digits, excluding the thumb, is rare and often has unique causes. This case highlights a juvenile trigger finger linked to a calcified nodule on the flexor digitorum superficialis tendon.

Area of Science:

Pediatric Orthopedics
Hand Surgery
Musculoskeletal Pathologies

Background:

Trigger finger (stenosing tenosynovitis) is common in adults but less frequent in pediatric patients.
When it occurs in children, it typically affects the thumb (trigger thumb).
Triggering of other digits in pediatric populations is uncommon and warrants investigation into unique etiologies.

Observation:

A juvenile patient presented with symptoms of a trigger finger affecting a digit other than the thumb.
Physical examination revealed a palpable abnormality associated with the affected digit's movement.
Imaging studies were performed to evaluate the underlying cause of the triggering.

Findings:

A solid calcified nodule was identified directly on the flexor digitorum superficialis tendon.

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This nodule was determined to be the causative agent for the stenosing tenosynovitis and triggering.

Histopathological analysis confirmed the nature of the calcified nodule.

Implications:

This case expands the known differential diagnoses for pediatric trigger digits.
It underscores the importance of considering unusual etiologies, such as calcified nodules, in pediatric hand conditions.
Surgical excision of the nodule may be curative, restoring normal digital function.