Complex trigger wrist associated with carpal tunnel syndrome: a case report

Area of Science:

• Hand Surgery
• Orthopedics
• Neurology

Background:

• Trigger wrist is a rare pathology with limited literature, often presenting diagnostic challenges.
• Neurological symptoms at the wrist, induced by movement, can impair function and sensitivity.
• Differentiating trigger wrist from trigger finger clinically and via MRI can be difficult.

Observation:

• A case report details a 45-year-old male with trigger wrist associated with carpal tunnel syndrome.
• The condition was caused by a fibroma of the flexor tendon sheath.
• Clinical examination and MRI failed to clearly distinguish between trigger finger and trigger wrist.

Findings:

• Surgical carpal tunnel release identified and excised a fibroma.
• Post-surgery, wrist function was well-maintained without carpal tunnel syndrome signs.
• A proposed diagnostic statement suggests referring to cases with trigger wrist and trigger finger symptoms (excluding A-1 pulley pain) as trigger wrist.

Implications:

• Accurate diagnosis of trigger wrist is crucial to avoid inadequate treatment for trigger finger.
• The proposed diagnostic criterion may aid clinicians in differentiating these conditions.
• This case highlights the importance of considering trigger wrist in complex wrist presentations.