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What Causes Trigger Fingers And Decreased Grip In Right Hand After Injury?
A 55 year old right hand dominant man slips on ice and falls on his right had and shoulder, unclear mechanism of injury but no fractures on plain films or MRIs. He develops trigger fingers of ring and small fingers, unresponsive to injections, oral pain meds and attempts at OT. He undergoes a right 3dr and 4th A1 pulley release /tenosynovectomy. At more than 15 months post op and OT he is still unable to make a composite fist , cannot completely bring in 3rd and 4th digits, has decreased grip strength in the right hand. Has scar tissue. ( neurodiagnostic studies normal). Is common for such injuries or is this case an exception? Has this individual reached maximal medical improvement? Many thanks. I Jeremiah, an Occ Med and FP doc.
Tue, 1 Feb 2022
Hello,
A 55 year old fell on ice and injured right hand and shoulder. Presently he is suffering from decreased grip strength. Decreased grip strength is indicative of inflammation of the joints, carpal tunnel syndrome, stress . strain injury or tear of the tendons of the elbow, etc. Immobilization of the wrist (limiting the use of hand) by a simple splint or brace reduces pain, inflammation and helps to bring back muscle and grip strength.
Exercises are helpful like wrist extension, wrist flexion, thumb touches, etc. He should get connected to a physical therapist. Nerve impingement or injury can also be a factor. Get repeat nerve conduction tests done. For relief, he can take NSAIDS and vitamin B6, B12 supplements. He is suggested to get clinically examined by an orthopedics, get required investigations done, he will be treated accordingly. Diabetic neuropathy, peripheral neuropathy, OA, smoking, etc., can trigger the symptoms.
Take care. Hope I have answered your question. Let me know if I can assist you further.
Regards,
Dr. Nupur K., General & Family Physician
A 55 year old fell on ice and injured right hand and shoulder. Presently he is suffering from decreased grip strength. Decreased grip strength is indicative of inflammation of the joints, carpal tunnel syndrome, stress . strain injury or tear of the tendons of the elbow, etc. Immobilization of the wrist (limiting the use of hand) by a simple splint or brace reduces pain, inflammation and helps to bring back muscle and grip strength.
Exercises are helpful like wrist extension, wrist flexion, thumb touches, etc. He should get connected to a physical therapist. Nerve impingement or injury can also be a factor. Get repeat nerve conduction tests done. For relief, he can take NSAIDS and vitamin B6, B12 supplements. He is suggested to get clinically examined by an orthopedics, get required investigations done, he will be treated accordingly. Diabetic neuropathy, peripheral neuropathy, OA, smoking, etc., can trigger the symptoms.
Take care. Hope I have answered your question. Let me know if I can assist you further.
Regards,
Dr. Nupur K., General & Family Physician
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