PDF herunterladen
CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(06): 911-916
DOI: 10.1055/s-0040-1713765
Artigo de Atualização
Mão

Tratamento do Dedo em Gatilho

Artikel in mehreren Sprachen: português | English
João Carlos Belloti 
1   Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
Edson Sasahara Sato 
1   Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
Flavio Faloppa 
1   Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Resumo

O dedo em gatilho é uma afecção frequente. Não obstante a tenossinovite e a alteração da polia A1 serem identificados como fatores desencadeantes, não há consenso sobre a verdadeira causa na literatura, sendo que a sua verdadeira etiologia permanece desconhecida. O diagnóstico é puramente clínico na maior parte das vezes. Ele depende unicamente da existência do travamento do dedo no decorrer da movimentação flexão ativa. O tratamento do dedo em gatilho geralmente se inicia com intervenções não cirúrgicas que são instituídas por pelo menos 3 meses. Nos pacientes em quem haja apresentação inicial com deformidade em flexão ou incapacidade de flexão do dedo, pode haver indicação mais precoce do tratamento cirúrgico em razão da intensidade do quadro álgico e da incapacidade funcional do paciente.

No presente artigo de revisão, apresentaremos as modalidades e o nosso algoritmo para o tratamento do dedo em gatilho.

Palavras-chave

dedo em gatilho/diagnóstico - dedo em gatilho/terapia - dedo em gatilho/cirurgia - tenossinovite


Publikationsverlauf

Eingereicht: 10. Januar 2020

Angenommen: 15. April 2020

Artikel online veröffentlicht:
22. September 2020

© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • Referências

  • 1 Notta A. Research on a particular condition of tendon sheaths of the hand, characterized by the development of a nodule in the path of flexor tendons and blocking their movements. Arch Gen Med 1850; 4 (24) 142-161
    Google Scholar
  • 2 Hueston JT, Wilson WF. The aetiology of trigger finger explained on the basis of intratendinous architecture. Hand 1972; 4 (03) 257-260
    CrossrefPubMedGoogle Scholar
  • 3 Brozovich N, Agrawal D, Reddy G. A Critical Appraisal of Adult Trigger Finger: Pathophysiology, Treatment, and Future Outlook. Plast Reconstr Surg Glob Open 2019; 7 (08) e2360
    CrossrefPubMedGoogle Scholar
  • 4 Quinnell RC. Conservative management of trigger finger. Practitioner 1980; 224 (1340): 187-190
    PubMedGoogle Scholar
  • 5 Lunsford D, Valdes K, Hengy S. Conservative management of trigger finger: A systematic review. J Hand Ther 2019; 32 (02) 212-221
    CrossrefPubMedGoogle Scholar
  • 6 N JHS, L AHAF, R GVG, da Silveira DCEC, B PN, Almeida SF. Epidemiology of Trigger Finger: Metabolic Syndrome as a New Perspective of Associated Disease. Hand (N Y) 2019; 28: 1558944719867135
    Google Scholar
  • 7 Ho SWL, Chia CY, Rajaratnam V. Characteristics and Clinical Outcomes of Open Surgery for Trigger Digits in Diabetes. J Hand Microsurg 2019; 11 (02) 80-83
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 8 Lin FY, Wu CI, Cheng HT. Coincidence or complication? A systematic review of trigger digit after carpal tunnel release. J Plast Surg Hand Surg 2018; 52 (02) 67-73
    Google Scholar
  • 9 Baek GH, Kim JH, Chung MS, Kang SB, Lee YH, Gong HS. The natural history of pediatric trigger thumb. J Bone Joint Surg Am 2008; 90 (05) 980-985
    CrossrefPubMedGoogle Scholar
  • 10 Kikuchi N, Ogino T. Incidence and development of trigger thumb in children. J Hand Surg Am 2006; 31 (04) 541-543
    CrossrefPubMedGoogle Scholar
  • 11 Moon WN, Suh SW, Kim IC. Trigger digits in children. J Hand Surg [Br] 2001; 26 (01) 11-12
    CrossrefPubMedGoogle Scholar
  • 12 Wolfe S, Hotchkiss RN, Pederson W, Kozin SH, Cohen M. Eds. Green's operative hand surgery. 7th. ed. Philadelphia: Elsevier; 2017
    Google Scholar
  • 13 Akhtar S, Bradley MJ, Quinton DN, Burke FD. Management and referral for trigger finger/thumb. BMJ 2005; 331 (7507): 30-33
    CrossrefPubMedGoogle Scholar
  • 14 Mifune Y, Inui A, Sakata R. et al. High-resolution ultrasound in the diagnosis of trigger finger and evaluation of response to steroid injection. Skeletal Radiol 2016; 45 (12) 1661-1667
    CrossrefPubMedGoogle Scholar
  • 15 Salim N, Abdullah S, Sapuan J, Haflah NH. Outcome of corticosteroid injection versus physiotherapy in the treatment of mild trigger fingers. J Hand Surg Eur Vol 2012; 37 (01) 27-34
    CrossrefPubMedGoogle Scholar
  • 16 Watanabe H, Hamada Y, Toshima T, Nagasawa K. Conservative treatment for trigger thumb in children. Arch Orthop Trauma Surg 2001; 121 (07) 388-390
    CrossrefPubMedGoogle Scholar
  • 17 Patel MR, Bassini L. Trigger fingers and thumb: when to splint, inject, or operate. J Hand Surg Am 1992; 17 (01) 110-113
    CrossrefPubMedGoogle Scholar
  • 18 Sato ES, Gomes Dos Santos JB, Belloti JC, Albertoni WM, Faloppa F. Treatment of trigger finger: randomized clinical trial comparing the methods of corticosteroid injection, percutaneous release and open surgery. Rheumatology (Oxford) 2012; 51 (01) 93-99
    CrossrefPubMedGoogle Scholar
  • 19 Mardani-Kivi M, Karimi-Mobarakeh M, Babaei Jandaghi A, Keyhani S, Saheb-Ekhtiari K, Hashemi-Motlagh K. Intra-sheath versus extra-sheath ultrasound guided corticosteroid injection for trigger finger: a triple blinded randomized clinical trial. Phys Sportsmed 2018; 46 (01) 93-97
    CrossrefPubMedGoogle Scholar
  • 20 Elena C, Chiara M, Angelica B. et al. Hyperglycemia and Diabetes Induced by Glucocorticoids in Nondiabetic and Diabetic Patients: Revision of Literature and Personal Considerations. Curr Pharm Biotechnol 2018; 19 (15) 1210-1220
    CrossrefPubMedGoogle Scholar
  • 21 Roberts JM, Behar BJ, Siddique LM, Brgoch MS, Taylor KF. Choice of Corticosteroid Solution and Outcome After Injection for Trigger Finger. Hand (N Y) 2019; •••: 1558944719855686
    Google Scholar
  • 22 Newport ML, Lane LB, Stuchin SA. Treatment of trigger finger by steroid injection. J Hand Surg Am 1990; 15 (05) 748-750
    CrossrefPubMedGoogle Scholar
  • 23 Eastwood DM, Gupta KJ, Johnson DP. Percutaneous release of the trigger finger: an office procedure. J Hand Surg Am 1992; 17 (01) 114-117
    CrossrefPubMedGoogle Scholar
  • 24 Sato ES, Albertoni WM, Leite VM, Santos JB, Faloppa F. Trigger finger: a prospective analysis of 76 fingers treated surgically by percutaneous release. Rev Bras Ortop 2004; 39 (06) 309-322
    Google Scholar
  • 25 Bain GI, Turnbull J, Charles MN, Roth JH, Richards RS. Percutaneous A1 pulley release: a cadaveric study. J Hand Surg Am 1995; 20 (05) 781-784 , discussion 785–786
    CrossrefPubMedGoogle Scholar
  • 26 Lee SH, Choi YC, Kang HJ. Comparative study of ultrasonography-guided percutaneous A1 pulley release versus blinded percutaneous A1 pulley release. J Orthop Surg (Hong Kong) 2018; 26 (02) 2309499018772368
    CrossrefPubMedGoogle Scholar
  • 27 Turowski GA, Zdankiewicz PD, Thomson JG. The results of surgical treatment of trigger finger. J Hand Surg Am 1997; 22 (01) 145-149
    CrossrefPubMedGoogle Scholar
  • 28 Leung OY, Ip FK, Wong TC, Wan SH. Trigger thumbs in children: results of surgical release. Hong Kong Med J 2011; 17 (05) 372-375
    PubMedGoogle Scholar
  • 29 Amirfeyz R, McNinch R, Watts A. et al. Evidence-based management of adult trigger digits. J Hand Surg Eur Vol 2017; 42 (05) 473-480
    CrossrefPubMedGoogle Scholar
  • 30 Fiorini HJ, Tamaoki MJ, Lenza M, Gomes Dos Santos JB, Faloppa F, Belloti JC. Surgery for trigger finger. Cochrane Database Syst Rev 2018; 2: CD009860
    PubMedGoogle Scholar