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Flexor tenosynovitis is a common finding in the patients with Linburg–Comstock syndrome. Another hypothesis is that anatomical variations, which in this case is an additional tendon slip, may act as space-occupying lesions and potentially contribute to carpal tunnel syndrome. [5]
The patient should be awake in order to confirm adequate release. On occasion, triggering does not resolve until a slip of the FDS (flexor digitorum superficialis) tendon is resected. [10] One study suggests that the most cost-effective treatment is up to two corticosteroid injections followed by open release of the first annular pulley. [13]
Surgery generally does not improve outcomes. [2] It may be required if the finger cannot be straightened by pushing on it or the break has pulled off more than 30% of the joint surface. [2] Surgery may be preferred over the use of a splint if a child is non-compliant. [5] If the problem has been present a long time surgery may also be required. [6]
Surgery may be needed for an unstable fracture (one that won't stay in the right place once reduced), [3] a finger broken in multiple places, [6] a fracture that extends into the joint between the broken bone and another bone, and a fracture with damaged tendon function [3] or damaged nerves.
The distal phalanx is especially vulnerable to avulsion fractures, where a fragment of bone is ripped off when the tendon separates from the phalanx. [1] Avulsion fractures are especially common following a first time dislocation. [1] These are especially concerning, as it may indicate a complete tear of the extensor digitorum tendon.
[5] [5]: 361 Localized/nodular TGCT (L-TGCT), sometimes referred to as “giant cell tumor of the tendon sheath”; [3]: 100 is a common tumor that presents as a slow-growing, encapsulated, localized and limited bump, most frequently in the fingers.