Rare Anatomic Causes for Symptomatic Triggering of the Hand and Fingers
While many New Yorkers are familiar with common hand issues like carpal tunnel syndrome, there are lesser-known anatomical conditions that can cause triggering sensations in the hand. At HandSport Surgery Institute (HSSI), Drs. Mark and Jason Pruzansky delve into these rare conditions, providing expert diagnosis and treatment right here in NYC. Let’s take a closer look at six that we have experience in treating.
Pseudo Triggering: MPJ Extensor Tendon Subluxation
Pseudo triggering, which involves the subluxation or partial dislocation of extensor tendons at the metacarpophalangeal joints, presents a unique challenge in hand functionality. Often, patients may experience a sudden ‘snap’ as the tendon slips out of its normal alignment. This condition not only causes discomfort but can also lead to swelling and instability in the affected joints.
We use specialized imaging techniques to diagnose this condition accurately and offer a range of treatments from targeted occupational therapy and splinting to minimally invasive surgical procedures aimed at stabilizing the tendon and restoring joint integrity.
Snapping Lateral Band Syndrome
Snapping lateral band syndrome occurs when the lateral bands of the extensor mechanism shift abruptly from the back of the finger middle joint to the side of the joint. This can cause a noticeable snap or pop during finger movements, often accompanied by pain and reduced mobility.
Our approach includes a thorough assessment to rule out associated conditions like tendonitis and tailored interventions that may include occupational therapy to strengthen surrounding muscles, or surgical correction to realign the extensor mechanism, providing long-term relief and improved finger function.
Snapping PIPJ or MPJ Collateral Ligaments
In cases where the collateral ligaments of the proximal interphalangeal or metacarpophalangeal joints are involved, patients may experience a snapping sensation accompanied by sudden sharp pain during joint movement. This condition often results from ligament or bony abnormalities.
Dr. Mark and Jason Pruzansky’s treatment strategy involves dynamic ultrasound imaging to assess the extent of ligament or bone disorders, and custom therapeutic approaches that may include splinting to stabilize the joint, or surgical repair techniques to restore ligament and joint function.
Partial Flexor Tendon Tear
Partial tears of the flexor tendons can be particularly deceptive as they might not completely sever the tendon but can significantly impair hand function. Symptoms often include localized pain, difficulty in flexing the fingers, and a feeling of the fingers ‘catching’ during movement.
At HSSI, we use advanced MRI techniques to visualize the extent of the tear and provide targeted treatments. These may range from conservative methods like splinting and anti-inflammatory medications to surgical interventions aimed at repairing the tendon.
Transverse Palmar Fascia Band Thickening
Transverse palmar fascia band thickening can lead to constriction and a pseudo-triggering sensation in the palm, often mistaken for classical trigger finger. This thickening can limit hand movement and cause discomfort and clicking.
Our approach includes non-invasive therapies such as corticosteroid injections to reduce thickening and occupational therapy to maintain hand mobility. In resistant cases, surgical removal of the thickened fascia bands may be considered to restore function.
PIPJ and MPJ Joint Abnormalities
Joint abnormalities in the proximal interphalangeal and metacarpophalangeal joints, such as bone or cartilage damage, can cause triggering sensations due to irregular joint mechanics because of surface defects. At HSSI, our detailed diagnostic process may include X-Ray, MRI, and CT imaging to accurately assess the damage.
Treatment options may include arthroscopic debridement to remove damaged tissue, or in advanced cases, joint reconstruction or replacement surgeries to restore joint integrity and function.
You’re in good hands. Let us help you!
At HandSport Surgery Institute in New York City, we understand that each patient requires a personalized approach, especially when dealing with rare hand conditions. If you’re experiencing unusual hand sensations or movements, don’t hesitate to reach out.
Contact us at 212-249-8700 or book a consultation online. Let Drs. Mark and Jason Pruzansky help you regain comfort and maximize the functionality in your hands with expert care tailored just for you.