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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]
Pain, depressed knuckle [2] Causes: Hitting an object with a closed fist [3] Diagnostic method: Based on symptoms and confirmed by X-rays [3] Treatment: Buddy taping and a tensor bandage, reduction and splinting [4] [3] Medication: Ibuprofen, paracetamol (acetaminophen) [3] Prognosis: Generally good [4] Frequency: 20% of hand fractures [4]
DIP dislocations may also involve a complete tear of the extensor digitorum tendon. [14] This tendon is part of a muscle that straightens the tip of the finger. [8] If left untreated, this may lead to permanent inability to straighten the finger at the affected DIP . [14] This particular type of injury is is known as 'mallet finger'.
Treatment of a partial tear or stretch injury is usually conservative. Most injuries that are partial and isolated can be treated without surgery. [3] This includes measures to control inflammation as well as bracing. Kannus has shown good clinical results with conservative care of grade II sprains, but poor results in grade III sprains. [6]
The surgery was called "controversial" by many sportswriters, due to a lack of studies on the long-term effects and the fact that an unsuccessful surgery could end an athlete's career. [9] Steadman has also adapted the surgery into a treatment to help reattach torn ligaments (a technique he calls the "healing response"). [citation needed]