Information
‘Fixed or intermittent deformity at the thumb IP joint ‘
Flexor tendon gliding is prevented due to impingement at level of the A1 pulley. This causes difficulty in flexing and extending the IPJ (thumb) and PIPJ (finger)
Symptoms: Pain, clicking, catching, locking of the digit in flexion
Diagnosis: Active triggering or fixed flexion, pain/tenderness over the A1 pulley (over metacarpal head/MCPJ of affected digit on the volar surface), palpable nodule over the A1 pulley of affected digit.
Differential: Check for signs of inflammation/infection, may be flexor tenosynovitis
If digit moving freely but painful, catching or intermittently locking please refer to stretching advice sheet and consider NSAIDs and referral to Hand Physio
If digit locked in flexion please refer to either Paediatric Orthopaedics or Plastic Surgeons
