Name:
Trigger Finger Injection Technique
Description:
Trigger Finger Injection Technique
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Duration:
T00H05M00S
Embed URL:
https://stream.cadmore.media/player/91f19caf-a506-4cfc-8c74-abff6f372755
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/91f19caf-a506-4cfc-8c74-abff6f372755/Trigger Finger Injection Technique.mp4?sv=2019-02-02&sr=c&sig=cTGiS0AQDNRiZsurm5WQSzTBI4XSSZr06oi%2B0gSSG7Q%3D&st=2024-11-23T09%3A41%3A06Z&se=2024-11-23T11%3A46%3A06Z&sp=r
Upload Date:
2024-05-31T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
With us today, I'm going to show you how to do a steroid injection for trigger finger. Now, trigger finger is an extremely common condition in orthopedic clinic, and it usually involves 1% to 2% of normal population. But if you are a diabetic, then the incidence of this is quite high and it has been quoted up to 10%, and it can also involve more than one finger.
Now, the treatment for these, if it is becoming symptomatic, is one shot of steroid injection. And if it makes it better, then it's fine. Otherwise, if there is a recurrence or if you don't see any improvement, then surgery or release of the A1 poly is the only option. So today I'm going to demonstrate you how to do a steroid injection safely without any complications.
So if you have a trigger finger, you will usually report pain across this area. So here, here, here, here. These are the areas where you will have pain. And if you feel, you will feel a nodule or a lump. And once you feel the lump and if you have a pain in early stages, that might be the only symptom. And that is quite classic for trigger finger. In later stages. if you bend on, open your fingers, close and open your fingers, then you might feel a sense of catching.
So your finger reflexes like this. And then when you extend, you will send a sense of catching or triggering and hence it is called trigger finger. In later stages your finger may bend and then you may have to use your other hand to extend it. And in final stages, even with your finger, you won't be able to extend. So that is probably the last stage.
And then that diagnosis is very easy at that stage. But in early stages, pain here and nodule here is quite classic. So now if you have to do the injection, this is your metacarpal. These are the flex attendants. And this is I have drawn an even pulley. So now you want to inject your solution between A1 pulley and just outside the flexor tendon.
So what we do is once we have given the local anesthetic, we will go vertically in. Vertically in till we are in the tendon and once we are in the tendon we will ask patient to flex, extend or bend or extend the finger, the affected finger. And once they bend or extend because needle is in the tendon. And as they will bend an extend, the needle will move and you will see movement of the needle and that will tell you that this is within the tendon.
And once you see that, all you need to do is to withdraw the needle slightly. So that they are just outside this tendon. And then ask them to move again. And once they move, then because now the needle is outside the tendon, that movement of the needle will disappear. That will tell you are in the space and once you are happy, then keep this needle still and then still.
And this will go across your A1 pulley and will flood this area and will deliver this in the target area. So I will demonstrate this when we will do this injection now. So our patient is now prepped. We have cleaned the whole hand with betadine and then we have washed it with some alcohol solution. So that is extremely important that you take care of sepsis. Now you can straightaway go and inject.
I am giving some local today. So as to reinforce the finding or the procedure that I talked about. So first thing is that I'm just going to take some local. So if you feel here, I can just feel a nodule there. And this is the finger that she is having trouble. So I'm just going to pierce the skin. And then just slowly give some local in that area.
Once you have given local anesthetic or if you want to go straight, this is the area where I feel the nodule. Normally, if you mark the distance from this metacarpal phyllangeal joint, still PIP carries this distance. If you reverse it on this direction, this is where you police. So we're just going to clean this area, go vertically, straighten.
And then you ask the patient to move the finger.
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