WordNet

search for on the computer; "I fingered my boss and found that he is not logged on in the afternoons"
the length of breadth of a finger used as a linear measure (同)fingerbreadth, finger''s breadth, digit
one of the parts of a glove that provides covering for a finger or thumb
any of the terminal members of the hand (sometimes excepting the thumb); "her fingers were long and thin"
feel or handle with the fingers; "finger the binding of the book" (同)thumb
indicate the fingering for the playing of musical scores for keyboard instruments
release or pull the trigger on; "Trigger a gun"
an act that sets in motion some course of events (同)induction, initiation
a device that activates or releases or causes something to happen
the placement of the fingers for playing different notes (or sequences of notes) on a musical instrument
touching something with the fingers
having or resembling a finger or fingers; often used in combination; "the fingered roots of giant trees"; "rosy-fingered"; "three-fingered cartoon characters"

PrepTutorEJDIC

(手の)『指』 / 指の形をしたもの;(手袋の)指;(メーターなどの)指針 / 指幅(びん入りの酒の量を測るときなど) / …‘に'指で触れる,‘を'指でいじる / 〈楽器など〉‘を'指でひく,つまびく
(銃砲の)引き金 / 《話》敏しような,抜け目のない / 〈一連の事件・反応など〉‘を'起こす,誘発する《+off+名,+名+off》
指で触れる(いじる)こと / (弦楽器おひくときの)運指法;運指記号
指状の;指でいじられた / (楽譜が奏法を指示する)指印のついた

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/03/16 06:53:09」(JST)

wiki en

Trigger finger, trigger thumb, or trigger digit (also a sub-set of stenosing tenosynovitis) is a common disorder characterized by catching, snapping or locking of the involved finger flexor tendon, associated with dysfunction and pain.^[1] A disparity in size between the flexor tendon and the surrounding retinacular pulley system, most commonly at the level of the first annular (A1) pulley, results in difficulty flexing or extending the finger and the “triggering” phenomenon.^[1] The label of trigger finger is used because when the finger unlocks, it pops back suddenly, as if releasing a trigger on a gun.

Causes

The cause of trigger finger is unclear but several causes have been proposed.^[1] It has also been called stenosing tenosynovitis (specifically digital tenovaginitis stenosans), but this may be a misnomer, as inflammation is not a predominant feature.

It has been speculated that repetitive forceful use of a digit leads to narrowing of the fibrous digital sheath in which it runs, but there is little scientific data to support this theory. The relationship of trigger finger to work activities is debatable and scientific evidence for^[2] and against^[3] hand use as a cause exist. While the mechanism is unclear, there is some evidence that triggering of the thumb is more likely to occur following surgery for carpal tunnel syndrome.^[4] it may also occur in rheumatoid arthritis

Diagnosis

Diagnosis is made almost exclusively by history and physical examination alone. More than one finger may be affected at a time, though it usually affects the index, thumb, middle, or ring finger. The triggering is usually more pronounced late at night and into the morning, or while gripping an object firmly.

Treatment

Post operative photo of trigger finger release surgery in a diabetic patient. See:^[5]

Injection of the tendon sheath with a corticosteroid is effective over weeks to months in more than half of patients.^[6]

When corticosteroid injection fails, the problem is predictably resolved by a relatively simple surgical procedure (usually outpatient, under local anesthesia). The surgeon will cut the sheath that is restricting the tendon.

One recent study in the Journal of Hand Surgery suggests that the most cost-effective treatment is two trials of corticosteroid injection, followed by open release of the first annular pulley.^[7] Choosing surgery immediately is the most expensive option and is often not necessary for resolution of symptoms.^[7] More recently, a randomized controlled trial comparing corticosteroid injection with needle release and open release of the A1 pulley reported that only 57% of patients responded to corticosteroid injection (defined as being free of triggering symptoms for greater than 6 months). This is compared to a percutaneous needle release (100% success rate) and open release (100% success rate).^[8] This is somewhat consistent with the most recent Cochrane Systematic Review of corticosteroid injection for trigger finger which found only 2 pseudo-randomized controlled trials for a total pooled success rate of only 37%.^[9] However, this systematic review has not been updated since 2009.

There is a theoretical greater risk of nerve damage associated with the percutaneous needle release as the technique is performed without seeing the A1 pulley.^[10]

Prognosis

The natural history of disease for trigger finger remains uncertain.

There is some evidence that idiopathic trigger finger behaves differently in people with diabetes.^[6]

Recurrent triggering is unusual after successful injection and rare after successful surgery.

While difficulty extending the proximal interphalangeal joint may persist for months, it benefits from exercises to stretch the finger straighter.

References

^ ^a ^b ^c Makkouk AH, Oetgen ME, Swigart CR, Dodds SD (June 2008). "Trigger finger: etiology, evaluation, and treatment". Curr Rev Musculoskelet Med 1 (2): 92–6. doi:10.1007/s12178-007-9012-1. PMC 2684207. PMID 19468879.
^ Gorsche R, Wiley JP, Renger R, Brant R, Gemer TY, Sasyniuk TM (June 1998). "Prevalence and incidence of stenosing flexor tenosynovitis (trigger finger) in a meat-packing plant". J Occup Environ Med 40 (6): 556–60. doi:10.1097/00043764-199806000-00008. PMID 9636936.
^ Kasdan ML, Leis VM, Lewis K, Kasdan AS (November 1996). "Trigger finger: not always work related". J Ky Med Assoc 94 (11): 498–9. PMID 8973080.
^ King, Bradley A.; Stern, Peter J.; Kiefhaber, Thomas R. (2013). "The incidence of trigger finger or de Quervain's tendinitis after carpal tunnel release". Journal of Hand Surgery (European Volume) 38 (1): 82–3. doi:10.1177/1753193412453424. PMID 22791612.
^ Eisen, Jonathan. "Trigger finger surgery. Fun.". Retrieved 17 May 2013.
^ ^a ^b Baumgarten KM, Gerlach D, Boyer MI (December 2007). "Corticosteroid injection in diabetic patients with trigger finger. A prospective, randomized, controlled double-blinded study". Journal of Bone and Joint Surgery (American) 89 (12): 2604–2611. doi:10.2106/JBJS.G.00230. PMID 18056491.
^ ^a ^b Kerrigan CL, Stanwix MG (Jul–Aug 2009). "Using evidence to minimize the cost of trigger finger care". J Hand Surg Am 34 (6): 997–1005. doi:10.1016/j.jhsa.2009.02.029. PMID 19643287.
^ Sato SS, et al. (2012). "Treatment of trigger finger: randomized clinical trial comparing the methods of corticosteroid injection, percutaneous release and open surgery". Rheumatology 51 (1): 93–99. doi:10.1093/rheumatology/ker315. PMID 22039269.
^ Peters-Veluthamaningal, C; van der Windt, DA; Winters, JC; Meyboom-de Jong, B (Jan 21, 2009). "Corticosteroid injection for trigger finger in adults.". The Cochrane database of systematic reviews (1): CD005617. doi:10.1002/14651858.CD005617.pub2. PMID 19160256. Cite uses deprecated parameter |coauthors= (help)
^ Bain, GI; Turnbull, J; Charles, MN; Roth, JH; Richards, RS (Sep 1995). "Percutaneous A1 pulley release: a cadaveric study.". The Journal of hand surgery 20 (5): 781–4; discussion 785–6. doi:10.1016/S0363-5023(05)80430-7. PMID 8522744.

External links

Video of Trigger Finger Release Surgery on YouTube
Hand World Trigger Finger Page
American Academy of Orthopaedic Surgeons information on trigger finger
Overview page from a UK surgeon
Information from the Mayo Clinic
Information from eMedicine

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. ばね指（狭窄性屈筋腱腱鞘炎） trigger finger stenosing flexor tenosynovitis
2. 筋骨格系超音波検査：関節およびその他の構造のガイド下での注射および吸引 musculoskeletal ultrasonography guided injection and aspiration of joints and related structures
3. 母指痛患者の評価 evaluation of the patient with thumb pain
4. 手の痛みを有する患者の評価 evaluation of the patient with hand pain
5. 糖尿病における筋骨格系の合併症 musculoskeletal complications in diabetes mellitus

English Journal

Percutaneous release, open surgery, or corticosteroid injection, which is the best treatment method for trigger digits?

Wang J, Zhao JG, Liang CC.SourceDepartment of Traumatic Orthopaedics, Tianjin Hospital, Tianjin, China.
Clinical orthopaedics and related research.Clin Orthop Relat Res.2013 Jun;471(6):1879-86. doi: 10.1007/s11999-012-2716-6. Epub 2012 Dec 4.
BACKGROUND: Percutaneous A1 pulley release surgery for trigger digit (finger or thumb) has gained popularity in recent decades. Although many studies have reported the failure rate and complications of percutaneous release for trigger digit, the best treatment for trigger digit remains unclear.QUEST
PMID 23208122

Intersubjective action-effect binding: Eye contact modulates acquisition of bidirectional association between our and others' actions.

Sato A, Itakura S.SourceFaculty of Human Development, University of Toyama, 3190 Gofuku, Toyama 930-8555, Japan. Electronic address: a_sato@edu.u-toyama.ac.jp.
Cognition.Cognition.2013 Jun;127(3):383-90. doi: 10.1016/j.cognition.2013.02.010. Epub 2013 Mar 28.
In everyday social life, we predict others' actions in response to our own actions. Subsequently, on the basis of these predictions, we control our actions to attain desired social outcomes and/or adjust our actions to accommodate the anticipated actions of the others. Representation of the bidirect
PMID 23542411

Japanese Journal

ばね指とPIP関節

南瑠那,安藤義博,西島直城
中部日本整形外科災害外科学会雑誌 58(1), 131-132, 2015
NAID 130005063414

Biomechanical aspects of trigger finger – which changed first, the pulley or the tendon?

, , , , ,
Journal of Biomechanical Science and Engineering 9(2), 13-00237-13-00237, 2014
… Although trigger finger is a relatively common hand disorder, its exact cause remains unknown. … The purpose of this review is to summarize what is known about the clinical and biomechanical presentation of trigger finger. … Kinematic and kinetic performance of trigger fingers has been evaluated in vivo. …
NAID 130004946305

Biomechanical aspects of trigger finger – which changed first, the pulley or the tendon?

, , , , ,
Journal of Biomechanical Science and Engineering, 2014
… Although trigger finger is a relatively common hand disorder, its exact cause remains unknown. … The purpose of this review is to summarize what is known about the clinical and biomechanical presentation of trigger finger. … Kinematic and kinetic performance of trigger fingers has been evaluated in vivo. …
NAID 130004691138

Related Pictures

★リンクテーブル★

リンク元	「ばね指」
拡張検索	「trigger finger disorder」
関連記事	「finger」「trigger」

「ばね指」

Trigger finger
Classification and external resources
Specialty	Plastic surgery
ICD-10	M65.3
ICD-9-CM	727.03
MedlinePlus	000565
eMedicine	orthoped/570
	[edit on Wikidata]