Trigger Thumb

Overview

4.3 out of 5 (11 Reviews)

Credits

1.00

Post Assessment Questions

5

Start Date

1 Sep 2023

Last Review Date

5 Feb 2024

Expiration Date

31 Aug 2026

Estimated Time To Finish

60 Minutes


 
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Activity Description

Trigger thumb or stenosing flexor tenosynovitis of the thumb is characterized by a narrowing of the flexor tendon sheath. This constriction results in the flexor tendon catching as it attempts to glide smoothly through the relatively stenotic sheath. Trigger thumb or trigger finger is caused by a size mismatch of the diameter between the swollen flexor tendon and its sheath at the level of the metacarpal head. The outcome is a noticeable clicking or popping sensation during attempts at thumb extension. Both the extrinsic flexor pollicis longus (FPL) and intrinsic flexor pollicis brevis (FPB) contribute to the flexion process. The FPL tendon travels within its sheath, passing through the A1, oblique, and A2 pulleys, with the A1 pulley positioned most proximally and the A2 pulley situated most distally. Notably, the A1 pulley overlaps the metacarpal bone, overlapping the metacarpophalangeal joint and the base of the proximal phalanx.

Trigger thumb typically results from the thickening of the A1 pulley, leading to pain and reduced functionality. Both adults and children can encounter trigger thumb. Although trigger thumb are predominantly acquired in adults, they are regarded as a rare developmental anomaly in children. Treatment for this condition commences with splinting and physical therapy. Intralesional steroid injections are suitable for patients unresponsive to conservative management. In cases where conservative measures prove insufficient, surgical release of the A1 pulley may be necessary to manage the condition effectively. This activity comprehensively reviews the etiology, diagnosis, evaluation, and management of trigger thumb while highlighting the crucial role of interprofessional healthcare teams in fostering collaboration to deliver well-coordinated care to patients with this condition.


Target Audience

This activity has been designed to meet the educational needs of physicians, physician associates, nurses, pharmacists, and nurse practitioners.

Learning Objectives

At the conclusion of this activity, the learner will be better able to:

  • Identify the clinical manifestations and characteristic clicking or popping sensation associated with trigger thumb during thumb extension.

  • Differentiate between trigger thumb and other conditions causing thumb dysfunction, considering both adult-acquired and pediatric presentations.

  • Apply conservative management strategies, including splinting and physical therapy, as initial interventions for trigger thumb, considering the patient's age and severity of symptoms.

  • Coordinate care seamlessly by collaborating with interprofessional healthcare teams, involving early assessment, timely intervention, and follow-up to optimize long-term outcomes for patients with trigger thumb.

Disclosures

StatPearls, LLC requires everyone who influences the content of an educational activity to disclose relevant financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. All relevant conflict(s) of interest have been mitigated. Hover over contributor names for financial disclosures. Others involved in planning this educational activity have no relevant financial relationships to disclose.

Commercial Support: This activity has received NO commercial support.

Continuing Education Accreditation Information

In support of improving patient care, StatPearls, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

 

Nurses: StatPearls designates this activity for 1.00 ANCC contact hour(s). Nurses should only claim credit commensurate with the extent of their participation in the activity.

Please consult your professional licensing board for information on the applicability and acceptance of continuing education credit for this activity.

Method of Participation and Credit

  1. Register for the activity.    
  2. Review the target audience, learning objectives, and disclosure information.
  3. Study the educational content of the enduring material.
  4. Choose the best answer to each activity test question. To receive credit and a certificate, you must pass the test questions with a minimum score of 100%.
  5. Complete the post-activity assessment survey.

If you have concerns regarding the CE/CME system, please contact support@statpearls.com.

Disclaimer

This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education. Faculty may discuss investigational products or off-label uses of products regulated by the US Food and Drug Administration. Readers should verify all information before employing any therapies described in this educational activity.

The information provided for this activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition. The information presented does not necessarily reflect the views of StatPearls or any commercial supporters of educational activities on statpearls.com. StatPearls expressly disclaims responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through a participant's misunderstanding of the content.

Unapproved Uses of Drugs/Devices: In accordance with FDA requirements, the audience is advised that information presented in this continuing education activity may contain references to unlabeled or unapproved uses of drugs or devices. Please refer to the FDA-approved package insert for each drug/device for full prescribing/utilization information.

Cancellation Policy: Please see the cancellation policy. StatPearls, LLC reserves the right to cancel any course due to unforeseen circumstances.

 

 
 

Reviews

Bonnie R. on 6/16/2021

Howard S. on 9/11/2021

Stephanie K. on 11/16/2021

Brandi F. on 2/28/2022

Ryan L. on 4/6/2022

Bonnie R. on 6/23/2022

Lisa R. on 9/25/2022

Daniel R. on 12/22/2022

Schuyler H. on 5/22/2023

Sadie H. on 8/21/2023

Denise W. on 10/22/2023

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