Trigger Thumb - The Secrets about Trigger Thumb - by an Orthopedic Hand Surgeon - what to do? — Transcript

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1. 0:03Okay.
2. 0:05Hello.
3. 0:06My name is Amir Aram MD.
4. 0:08I'm an orthopedic hand surgeon at Kaplan
5. 0:11Medical Center
6. 0:12in Rehovot in Israel.
7. 0:15Today we'll be talking about trigger
8. 0:17thumb.
9. 0:19The trigger thumb is actually a
10. 0:21situation where your thumb triggers,
11. 0:23goes up and down, and it gets stuck
12. 0:25along the way.
13. 0:27But first, a disclaimer.
14. 0:30This is not medical advice
15. 0:32that you should be using. We are just
16. 0:33giving you knowledge. You can apply some
17. 0:36of the things I say here, but you should
18. 0:38remember that this does not come instead
19. 0:41of a professional medical
20. 0:45assistance that you can approach where
21. 0:47you wherever you live around the globe.
22. 0:50And we'll be talking today about trigger
23. 0:52thumb.
24. 0:54As you can see here,
25. 0:56there is a pulley,
26. 0:58which is actually covering
27. 1:00the flexor tendon, which flexes my own
28. 1:03thumb.
29. 1:05This pulley here keeps my tendon in
30. 1:09check and holds it close to the bone.
31. 1:12The pulley, when you have trigger thumb,
32. 1:15becomes
33. 1:17constrained and constrains
34. 1:19the tendon. We recently published a
35. 1:22paper talking about the proximal area of
36. 1:25the pulley as being the culprit of this
37. 1:29type of problem. So, what happens is the
38. 1:32pulley becomes
39. 1:34con- uh constrained, it presses down on
40. 1:37the tendon, and you might might have
41. 1:39synovitis and inflammation, and local
42. 1:42pain here at the bottom of your thumb.
43. 1:45The solution this case is conservative
44. 1:48versus surgical. Conservative treatment
45. 1:51will include probably a splint, might
46. 1:54include physiotherapeutic treatment,
47. 1:58might include putting some local cream
48. 2:01or taking
49. 2:03general nonsteroidal anti-inflammatory
50. 2:05drugs.
51. 2:06And if this all fails, we can also try
52. 2:09using a local injection of steroids to
53. 2:13the area of the pulley.
54. 2:15Although this injection might endanger
55. 2:18the flexor tendon flexing your thumb,
56. 2:20which is already suffering due to the
57. 2:23trigger thumb that you have.
58. 2:25When we opt for a surgical intervention,
59. 2:28this is usually done under local
60. 2:30anesthesia. And what we do is
61. 2:34we
62. 2:35make a slit right here in the middle of
63. 2:37your A1 pulley,
64. 2:40which then releases the tendon. We might
65. 2:43also add a synovectomy cleaning around
66. 2:47this tendon. And this will allow your
67. 2:48thumb to move quite freely after the
68. 2:52surgery.
69. 2:53Afterwards, we will stitch up the skin.
70. 2:56And within about 12 days, we'll remove
71. 2:58the stitches. And you will be able to
72. 3:01move your thumb clearly and without any
73. 3:04pain.
74. 3:05This is a very good surgery with a very
75. 3:08high satisfaction with the patients.
76. 3:12My name is Amir R. MD.
77. 3:14I'm an orthopedic hand surgeon. And I
78. 3:16would like to thank you for watching
79. 3:19this movie and all the health to you.
80. 3:21Thank you.