Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a chief complaint of [finger/thumb] locking, catching, or snapping during flexion and extension. Symptoms are associated with localized pain at the level of the A1 pulley and morning stiffness. Patient denies history of trauma. Symptoms are exacerbated by repetitive gripping activities.
Clinical Examination Findings
Physical examination reveals a palpable, tender nodule at the level of the A1 pulley. Active range of motion demonstrates a mechanical block with audible or palpable snapping during transition from flexion to extension. No signs of infection, erythema, or distal neurovascular deficit. Finkelstein test negative.
Treatment Protocol
Treatment plan initiated with activity modification, NSAIDs, and splinting of the affected digit in extension at night. Corticosteroid injection into the A1 pulley sheath discussed and performed. If symptoms persist, surgical release of the A1 pulley will be considered.