TRIGGER FINGER

Fardhian Zaenal (030.10.101)Pembimbing : dr. Gatot Ibrahim W, Sp.OT, (K) spineRSUD Kota BekasiFK Universitas TrisaktiMei 2015TRIGGER FINGERIntroduksiStenosing tenosinovitis disebabkan oleh peradangan pada selubung tendon fleksor

Epidemiologilebih sering terjadi pada penderita diabetesJari manis yang paling sering terlibat

MekanismeDisebabkan oleh jebakan dari tendon fleksor pada tingkat katrol A1Metaplasia fibrocartilaginous tendon dan katrol ditemukan dalam patologi

Kondisi terkaitDiabetes mellitusRadang sendiAmiloidosis

ANATOMIKatrol fleksor jariA1 di atas sendi MP

OtotFDPFDS

ANATOMI

Flexor Digitorum ProfundusANATOMI

Flexor Digitorum SuperficialisANATOMI

ANATOMI

KLASIFIKASIGreen ClassificationKelas INyeri di daerah katrol A-1Kelas IIDigit tertahanKelas IIIDigit terkunci, bisa diperbaiki secara pasifKelas IVTerfiksasi, digit terkunciMANIFESTASI KLINISGejalaFinger clickingNyeri di telapak distal dekat katrol A1Jari menjadi terkunci dalam posisi fleksi

Pemeriksaan fisikNyeri tekan pada katrol A1Teraba benjolan di dekat lokasi yang samaDIAGNOSISPengkajianAnamnesisPemeriksaan fisik

Pemeriksaan radiologis tidak diperlukanPENATALAKSANAANNonoperative night splinting, activity modification,NSAIDS indications first line of treatmentsteroid injections indications best initial treatment for fingers, not for thumbtechnique give 1 to 3 injections in flexor tendon sheathdiabetics do not respond as well as non-diabeticsOperative surgical debridement and releaseof the A-1 pulley indications in cases that fail nonoperative treatmentrelease of A1 pulley and 1 slip of FDS (usually ulnar slip) indications pediatric trigger finger presents with Notta's nodule (proximal to A1 pulley), flexion contracture and triggeringmay need to release remaining FDS slip and A3 pulley as wellTEKNIK PEMBEDAHANSurgical debridement and releaseof the A-1 pulleyapproach longitudinal or transverse incisionrelease technique in children, in addition to A-1 pulley release, may also need to release one or both limbs of the sublimus tendonA-2 pulleyA-3 pulleypostoperative early passive andactive ROM4 times a dayif patient does not have FROM at first post-op visit then send to PT

KOMPLIKASIRadial digital nerve injuryTERIMA KASIH