Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a chief complaint of locking, catching, and pain at the base of the left palm. Symptoms are most pronounced upon awakening. Patient reports associated tenderness and occasional snapping sensation during digital flexion and extension of the affected digit. No history of acute trauma. Symptoms are progressive, interfering with activities of daily living.
Clinical Examination Findings
Physical examination of the left hand reveals a palpable, tender nodule at the level of the A1 pulley. Positive triggering phenomenon noted during active flexion and extension of the affected digit. No signs of infection, erythema, or significant edema. Neurovascular status is intact distally. Range of motion is limited by mechanical locking.
Treatment Protocol
Treatment plan initiated with conservative management: activity modification, non-steroidal anti-inflammatory drugs (NSAIDs), and splinting of the affected digit. Corticosteroid injection into the A1 pulley sheath discussed and performed. Patient advised on potential risks and benefits. Follow-up scheduled in 4-6 weeks to assess for resolution or need for surgical release.