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Ganglion ng Flexor Tendon Sheath

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A benign, fluid-filled cyst arising from the flexor tendon sheath – often painless, but can cause clicking or limited finger movement.

Updated Jun 2026
Isang guhit-kamay na ilustrasyon ng maliit na matigas na butil sa base ng isdal
Isang ganglion ng flexor sheath: isang maliit na matigas na sista sa base ng daliri. Kieran Hirpara 4.0

Ang pahinang ito ay isinalin ng makina at hindi pa nasusuri ng isang doktor. Ang bersyong Ingles ang siyang opisyal.

Ano ang nararamdaman mo

Maaaring mapansin mo ang pagkabuo o pamamaga sa palad ng iyong pulso o kamay. Ito ay isang ganglion cyst, na isang karaniwang, hindi kanserosong sac na puno ng likido. Ito ay matatagpuan malapit sa mga tendon na yumuyuko sa iyong mga daliri. Maaaring mararamdaman mo ang matinding sakit sa lugar na ito. Karaniwang dumadating at umuubos ang sakit. Ito ay karaniwang lumalala pagkatapos mong gamitin ang iyong kamay nang matagal. Maaari ring mararamdaman mo ang hindi komportableng pakiramdam kapag gising ka pa lang sa umaga.

Habang umuunlad ang kondisyon, maaaring maranasan mo ang triggering. Ito ay nangyayari kapag pinalaki ang tendon at nahuhuli habang gumagalaw ito sa loob ng kanyang sheath. Maaaring ma-lock ang iyong daliri sa isang nakayuko na posisyon. Maaaring kailanganin mong gamitin ang iyong ibang kamay upang ito ay tuwidin. Ang pakiramdam ng pagka-catch ay maaaring magdulot ng takot at hindi komportableng pakiramdam. Sa ilang kaso, ang cyst mismo ay pumipindot sa tendon sa pulso, na nagdudulot ng katulad na mga isyu sa pagka-lock.

Ang mga pang-araw-araw na gawain ay maaaring maging mahirap. Ang mga simpleng galaw tulad ng pag-abot sa likod upang isara ang bra ay maaaring masakit. Ang pagtutukoy ng isang kamiseta o paghawak sa manibela ng sasakyan ay maaaring maging matigas at masakit. Maaari kang iwasan ang pag-angat ng mabibigat na bagay dahil ito ay nagpapalala sa lugar. Ang pagtulog sa gilid ng iyong apektadong kamay ay maaaring maging partikular na hindi komportable dahil sa presyon sa pagkabuo.

Mahalagang malaman na ang mga sintomas na ito ay madaling pamahalaan. Ang iyong surgeon ay makakatulong sa iyo upang maunawaan mo nang eksakto kung ano ang nangyayari sa loob ng iyong kamay. Habang ang pinalalaki ng tendon ay karaniwang nangyayari bago maranasan ang triggering, ang sakit at katigasan ay tunay at wasto. Hindi mo isinasaalang-alang ang hirap sa mga araw-araw na galaw na ito. Ang mga opsyon sa paggamot, tulad ng pagsasagawa ng operasyon para alisin ang cyst, ay simpleng epektibo. Ang pamamaraang ito ay naglalayong bawasan ang iyong sakit at ibalik ang maayos na galaw sa iyong mga tendon.

Ano ang nangyayari talaga

Ang ganglion ay isang bula na puno ng likido na bumubuo sa tabi ng iyong mga tendon. Sa kasong ito, nasa loob nito ang sheath na sumasakop sa flexor tendon. Ang sheath na ito ay ang madulas na tunnel na nagpapahintulot sa iyong tendon na dumulas nang maayos habang yumuyuko ang iyong mga daliri. Isipin ang tendon bilang isbina at ang sheath bilang manggas na nakapalibot dito. Ang ganglion ay isang maliit na balon ng likido na lumalabas sa manggas na ito.

Ang bula na ito ay maaaring magdulot ng sakit at magpahirap sa paggalaw ng iyong daliri. Maaaring ramdam mo na ang daliri ay nakakadikit o nakakalock. Maaaring alisin ng iyong surgeon ang ganglion na ito nang ligtas. Ang surgical excision ay isang simpleng, ligtas, at epektibong paraan para gamutin ang masakit na ganglion sa digital flexor tendon sheath. Ang layunin ay alisin ang iyong sakit at ibalik ang normal na paggalaw.

Kapag nagagamot ang ganglion na lumalago sa loob ng tendon mismo, pinapansin ng iyong surgeon ang karagdagang pag-iingat. Maaaring mahina ng ganglion ang mga hibla ng tendon. Kaya't dapat kasama sa paggamot ang pagpapanatili ng tendon. Alisin ng iyong surgeon ang cyst habang pinapanatili ang lakas at integridad ng tendon. Tinitiyak ng paraang ito na makakapagpatuloy ka sa paggamit ng iyong kamay nang walang pangmatagalang kahinaan.

Ang pag-unawa kung paano gumagana ang mga estrukturang ito ay tumutulong magbigay-liwanag sa iyong mga sintomas. Ang tendon at ang mga nakapalibot nitong tisyu ay dinisenyo para sa makinis, paulit-ulit na galaw. Kapag mayroong ganglion, binabago nito ang daloy na ito. Lumilikha ito ng friction at pressure sa makitid na espasyo ng daliri o hinlalaki. Ito ang dahilan kung bakit nararamdaman mo ang kahirapan o stiffness. Sa pamamagitan ng pagtugon sa pinagmulan ng iritasyon, tinutulungan ng iyong surgeon ang iyong kamay na bumalik sa kanyang natural na function.

Mga maitutulong namin dito

Maaari kang magsimula sa sariling pamamahala at pisyikal na terapiya. Maaaring irekomenda ng iyong doktor ang paggamit ng splint upang pahintulutan ang pagpapahinga ng kamay at pulso. Nakakatulong ito upang bawasan ang panghihikahos sa balutan ng tendon. Layunin ng pisikal na terapiya na panatilihing maayos ang galaw ng kasukasuan. Maaari ring subukan ang banayad na mga ehersisyo upang mapabuti ang lakas. Karaniwang sapat ang mga hakbang na ito na hindi operasyon upang mapamahalaan ang mga sintomas. Bigyan ng patas na pagsubok ang pamamaraang ito bago isaalang-alang ang mas invasive na mga opsyon.

Kung hindi magdudulot ng sapat na ginhawa ang pagpapahinga at terapiya, maaaring talakayin ng iyong doktor ang medikal na pamamahala. Nakakatulong ang mga gamot pang-alis ng sakit at anti-inflammatories upang kontrolin ang hindi komportableng pakiramdam. Ang mga injeksyon ay isa pang karaniwang opsyon. Binabawasan ng mga injeksyon ng cortisone ang pamamaga at pinapahinahon ang panghihikahos sa balutan. Maaaring tumulong ang mga injeksyon ng hyaluronic acid upang lubrikahan ang espasyo ng kasukasuan. Ginagamit ng mga injeksyon ng platelet-rich plasma (PRP) ang mga komponente ng iyong sariling dugo upang suportahan ang paggaling. Direktang tinatarget ng mga tratong ito ang sakit at katigasan. Maaaring mag-iba ang epekto ng mga injeksyon na ito, ngunit madalas na nagbibigay sila ng malaking ginhawa sa loob ng ilang buwan. Pipiliin ng iyong doktor ang pinakamainam na uri ng injeksyon para sa iyong partikular na kaso. Para sa trigger finger na dulot ng volar wrist ganglion, maaaring maging opsyon ang mga interbensyong radiolohikal sa halip na bukas na operasyon. Ipakita ng minimally invasive na teknika ng karayom-kutsilyo na may 99% rate ng kasiyahan at walang pinsala sa mga flexor tendon, arterya, o nerbiyos. Kapag kinakailangan ang mga injeksyon, ang mid-axial injection technique ang pinakamainam na paraan upang ipasok ang gamot sa balutan nang hindi nakakasama ang tendon mismo.

Ang operasyon ay itinuturing lamang kapag naabot na ng konservatibong alaga ang hangganan nito. Ibig sabihin, sinubukan mo na ang pagpapahinga, terapiya, at mga injeksyon nang walang pangmatagalang pagpapabuti. Talakayin ng iyong doktor ang pagsasagawa ng surgical excision kung patuloy na nakakaramdam ng sakit o nakakapaglimita sa iyong galaw ang ganglion. Ito ay isang simpleng, ligtas, at epektibong paraan upang gamutin ang nakakaramdam ng sakit na ganglion ng balutan ng digital flexor tendon. Ang layunin ay alisin ang sista habang pinapanatili ang tendon. Dahil maaaring mahina ang tendon ng mga ganglion, magiging maingat ang iyong doktor upang protektahan ito sa panahon ng operasyon. Detalyado ang operasyon mismo sa kanyang sariling pahina, ngunit ang pangunahing layunin ay alisin ang iyong sakit at ibalik ang normal na pag-andar.

Ano ang inaasahan

Ang ganglion cyst sa flexor tendon sheath ng iyong daliri ay isang karaniwan, benign na bula. Ito ay hindi kanser at hindi ito kumakalat. Maaaring mapansin mo na ang bula ay lumalabas at nawawala sa paglipas ng panahon. May mga taong nakakaramdam ng walang sakit, habang ang iba ay nakakaranas ng hindi komportable o stiffness.

Kung pipiliin mong hayaan ito, ang cyst ay maaaring manatiling pareho ang laki, mawala, o mawala nang sarili. Gayunpaman, maaari itong lumaki o maging mas masakit. Kung ang cyst ay pumipindot sa tendon, maaari itong magdulot ng triggering, kung saan ang iyong daliri ay nakakabit o nakakalock kapag binabangon mo ito. Ang pagpapalaki ng tendon na ito ay kadalasang nangyayari bago mo maranasan ang anumang pakiramdam ng locking, maliban sa hinlalaki.

Ang surgical removal ay isang simpleng, ligtas, at epektibong paraan upang gamutin ang masakit na ganglion. Ang iyong surgeon ay tatanggalin ang cyst habang maingat na pinapanatili ang tendon. Ang tendon ay maaaring mahina dahil sa cyst, kaya ang pagprotekta dito ay isang mahalagang bahagi ng proseso. Maraming pasyente ang nakakaramdam na ang pagtanggal ng cyst ay nagpapagaan ng sakit at nagpapabuti ng function ng kamay.

Ang recovery ay kinabibilangan ng paggaling ng balat at pagpapahintulot sa tendon na gumalaw nang malaya muli. Maaaring maranasan mo ang ilang stiffness sa iyong daliri pagkatapos ng proseso. Ito ay normal. Kahit may maingat na paggamot, ang ilang residual stiffness ay maaaring manatili sa loob ng ilang panahon habang ang mga tissue ay nagse-settle. Ang iyong surgeon ay magbibigay-daan sa iyo sa mga banayad na galaw upang panatilihin ang flexibility ng daliri nang hindi pinipilit ang repair.

Karamihan sa mga tao ay bumabalik sa kanilang normal na araw-araw na gawain habang bumababa ang pamamaga at bumabalik ang lakas. Ang layunin ay maging walang sakit na daliri na gumagalaw nang maayos. Habang ang mga resulta ay karaniwang maganda, ang mga indibidwal na resulta ay maaaring mag-iba base sa kung paano gumagaling ang iyong katawan. Ang iyong surgeon ay talakayin kung ano ang realistic para sa iyong partikular na sitwasyon sa panahon ng iyong consultation.

Kailan kumonsulta sa doktor

Humingi ng pagsusuri ng espesyalista kung mapansin mo ang pamamaga sa iyong kamay o pulso. Ang mga ganglion cyst ay karaniwang benign na lesyon na maaaring magpakita bilang mga pamamagang ito. Humingi ng paggamot kung may nararamdaman mong triggering pathology sa pulso, dahil ang isang volar wrist ganglion ay maaaring magpakita sa paraang ito. Pumunta sa iyong GP kung mayroon kang patuloy na sakit na hindi gumagaling kahit pahinga. Humingi ng pagsusuri ng espesyalista kung nararamdaman mong kahinaan o kawalan ng katatagan. Pumunta sa iyong doktor kung ang iyong daliri ay nakakabit o biglang bumabagsak. Humingi ng tulong kung ang mga sintomas ay nakakaapekto sa pagtulog o trabaho. Biglaang paglala ng mga senyales na ito ay nangangailangan din ng mabilis na pagsusuri. Ang klinikal na pagsusuri ay isang mahalagang kasangkapan para sa pagtukoy ng flexor disease, kaya ang propesyonal na pagsusuri ay susi upang makakuha ng tamang diagnosis at gamutan.

Reviewed by Dr Kieran Hirpara · 10 June 2026.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

Overview

  • Flexor tendon thickening occurs significantly before patients experience triggering, except in the thumb [1].
  • Surgical excision is a simple, safe, and effective method for treating a painful ganglion of the digital flexor tendon sheath [2].
  • Treatment of an intratendinous ganglion should include preserving the tendon, which may be weakened by the ganglion [3].

Anatomy & Pathophysiology

  • The flexor tendon thickens significantly before patients experience triggering, except in the thumb [1].
  • The A1 pulley confluence varies on a digit-to-digit basis, with no observed confluence in the thumb and the most common confluence observed in the middle finger [36].
  • Hand surface landmarks clarify the localization of the thumb A1 pulley and digital neurovascular structures [28].
  • Relative motion between a tendon and subsynovial connective tissue (SSCT) in the carpal tunnel is maximal at extremes of wrist motion, particularly 60° extension, which may predispose the SSCT to shear injury [32].
  • The active finger protocol requires the strongest tension of the flexor digitorum profundus tendon and results in the longest excursion [33].
  • The relative motion concept harnesses normal functional anatomic relationships of the extensor digitorum communis (EDC) and flexor digitorum profundus (FDP) muscles to vary forces on finger joints, allowing immediate controlled active motion while reducing undesirable tension [29].
  • Injury to the extensor mechanism, specifically the central slip, can lead to snapping or catching at the proximal interphalangeal (PIP) joint [35].
  • Understanding dynamic and passive stabilizing mechanisms is essential for diagnosing imbalance and for planning reconstructive strategies that restore movement [27].
  • Hand surgery and hand therapy practice interventions, including the use of relative motion flexion (RMF) orthoses for management of non-surgical and surgical extensor mechanism (EM) injuries, may benefit from an in-depth look at EM zone III and IV anatomy and biomechanics [26].

Classification

  • Flexor tendon thickening occurs significantly before patients experience triggering, except in the thumb [1].
  • Adherence around the flexor tendons contributes to the pathology of trigger finger and may be present in all grades of triggering [6].

Clinical Presentation

  • Flexor tendon thickening occurs significantly before patients experience triggering, except in the thumb [1].
  • Adherence around the flexor tendons contributes to the pathology of trigger finger and may be present in all grades of triggering [6].
  • The A0 pulley is implicated as the primary cause of 31% to 47% of trigger fingers [18].
  • Ganglion cysts are common benign lesions that may present as masses in the hand and wrist [11].
  • A volar wrist ganglion can present with triggering pathology at the wrist [10].
  • An intratendinous ganglion in the extensor pollicis longus tendon can cause tenosynovitis [3].
  • Clinical examination is a valuable tool for detecting flexor disease due to its high specificity and positive predictive values, although a negative examination does not exclude inflammation [37].
  • Tendinopathies involving the hand and wrist are common and often diagnosed easily [9].
  • Unilateral absence of the ring finger flexor digitorum profundus musculotendinous structure can pose a diagnostic challenge when history and examination suggest an acute avulsion injury [23].

Investigations

  • Sonographic evaluation can assess the flexor tendon, volar plate, and A1 pulley with respect to trigger finger severity [1].
  • Flexor tendon thickening occurs significantly before patients experience triggering, except in the thumb [1].
  • Adherence around the flexor tendons contributes to trigger finger pathology and may be present in all grades of triggering [6].

Treatment

  • Surgical excision is a simple, safe, and effective method for treating a painful ganglion of the digital flexor tendon sheath [2].
  • Ganglion cysts may be managed with reassurance, nonoperative treatment such as aspiration, or surgical excision [11].
  • Treatment of an intratendinous ganglion should include preserving the tendon, which may be weakened by the ganglion [3].
  • A volar wrist ganglion presenting as trigger finger can be treated with interventional radiological measures rather than open surgery [10].
  • The minimally invasive needle-knife technique for trigger finger achieved a 99% satisfactory result rate with no injuries to flexor tendons, arteries, or nerves [15].
  • Compared to other common non-image guided flexor tendon sheath injection techniques, the mid-axial injection technique was found to be the most accurate in producing all intra-sheath injection and least likely to result in intra-tendinous injection [13].
  • Tendinopathies involving the hand and wrist are managed straightforwardly with nonsurgical treatments such as splinting, injection, or therapy, or surgical techniques such as tendon release [9].

Complications

  • Flexor tendon thickening occurs significantly before patients experience triggering, except in the thumb [1].
  • Adherence around the flexor tendons contributes to the pathology of trigger finger and may be present in all grades of triggering [6].
  • The A0 pulley is implicated as the primary cause of 31% to 47% of trigger fingers [18].
  • Surgical excision is a simple, safe, and effective method for treating a painful ganglion of the digital flexor tendon sheath [2].
  • Treatment of an intratendinous ganglion should include preserving the tendon, which may be weakened by the ganglion [3].
  • Ganglion cysts are common benign lesions that may be managed with reassurance, nonoperative treatment such as aspiration, or surgical excision [11].
  • A volar wrist ganglion can present as trigger finger [10].
  • Even otherwise healthy patients can expect some residual digital stiffness following flexor tendon sheath infection despite aggressive and prompt antibiotic therapy and surgical intervention [7].
  • The outcome of a flexor tendon repair is influenced by many factors that cannot be controlled intraoperatively [4].
  • Whether or not to repair the flexor digitorum superficialis in acute Zone 2B injuries is an intraoperative decision based on the ease of gliding of the repaired tendon(s) [5].
  • Six-strand repair technique is an effective procedure to assure early active motion after flexor pollicis longus tendon injuries, and good results can also be achieved by omitting the circumferential suture [12].
  • Minimally invasive needle-knife release achieved a 99% satisfactory result rate with no injuries to flexor tendons, arteries, or nerves [15].

Recovery

  • Surgical excision is a simple, safe, and effective method for treating a painful ganglion of the digital flexor tendon sheath [2].
  • Treatment of an intratendinous ganglion should include preserving the tendon, which may be weakened by the ganglion [3].
  • The outcome of a flexor tendon repair is influenced by many factors that cannot be controlled intraoperatively [4].
  • Whether or not to repair the flexor digitorum superficialis in acute Zone 2B injuries is an intraoperative decision based on the ease of gliding of the repaired tendon(s) [5].
  • Despite aggressive and prompt antibiotic therapy and surgical intervention, even otherwise healthy patients can expect some residual digital stiffness following flexor tendon sheath infection [7].
  • The use of patient-reported outcomes, in addition to clinician-reported outcomes, provided deeper insight into patients' perceptions of their recovery after flexor tendon injury [8].
  • A six-strand repair technique is an effective procedure to assure early active motion after flexor pollicis longus tendon injuries [12].
  • Good results can be achieved by omitting the circumferential suture in six-strand flexor pollicis longus tendon repairs [12].
  • The wide-awake approach to flexor tendon repair has decreased rupture and tenolysis rates and permitted consistently good results in cooperative patients [17].
  • The hand requires a stable wrist and at least two sensate digits that can oppose with some power for functional prehension [20].
  • A patient with congenital hypoplasia of the extensor tendons of the fingers regained nearly full extension of the affected fingers at 6 months and was able to return to work [25].

Key Evidence

  • [L4] The flexor tendon thickened significantly before patients experienced triggering except in the thumb. [1] (10.1016/j.jhsa.2012.06.027)
  • [L4] Surgical excision is a simple, safe, and effective method for treating a painful ganglion of the digital flexor tendon sheath. [2] (10.1007/s11552-007-9028-4)
  • [Case_report] Treatment of the intratendinous ganglion should include preserving the tendon, which may be weakened by the ganglion. [3] (10.1177/1753193412453428)
  • [L4] The outcome of a flexor tendon repair is influenced by many factors that cannot be controlled intraoperatively. [4] (10.1016/j.jhsa.2022.01.015)
  • [L3] Whether or not to repair flexor digitorum superficialis is an intraoperative decision based on the ease of gliding of the repaired tendon(s). [5] (10.1177/1753193420932446)
  • [L2] Adherence around the flexor tendons contributes to the pathology of trigger finger and may be present in all grades of triggering. [6] (10.1177/1753193420969293)
  • [L5] Despite aggressive and prompt antibiotic therapy and surgical intervention, even otherwise healthy patients can expect some residual digital stiffness following flexor tendon sheath infection. [7] (10.5435/jaaos-20-06-373)
  • [L3] The use of patient-reported outcomes, in addition to clinician-reported outcomes, provided deeper insight into patients' perceptions of their recovery after flexor tendon injury. [8] (10.1016/j.jht.2024.12.011)
  • [L5] Tendinopathies involving the hand and wrist are common, often diagnosed easily, and managed straightforwardly with nonsurgical treatments such as splinting, injection, or therapy, or surgical techniques such as tendon release. [9] (10.5435/jaaos-d-14-00216)
  • [L4] This is the first reported case of triggering pathology at the wrist to be treated with interventional radiological measures rather than open surgery and demonstrates the efficacy of the technique. [10] (10.1177/1753193412453699)
  • [L5] Ganglion cysts are common benign lesions that may be managed with reassurance, nonoperative treatment such as aspiration, or surgical excision. [11] (10.1016/j.hcl.2004.03.015)
  • [L3] Six-strand repair technique is an effective procedure to assure early active motion after flexor pollicis longus tendon injuries and good results can also be achieved by omitting the circumferential suture. [12] (10.1177/15589447211057295)
  • [L5] Compared to other common non-image guided flexor tendon sheath injection techniques, the mid-axial injection technique was found to be the most accurate in producing all intra-sheath injection and least likely to result in intra-tendinous injection. [13] (10.1177/15589447221093676)
  • [L4] The minimally invasive needle-knife overcomes disadvantages of previously reported knives and achieved a 99% satisfactory result rate with no injuries to flexor tendons, arteries, or nerves. [15] (10.1177/1753193411436294)
  • [L5] The wide-awake approach to flexor tendon repair has decreased rupture and tenolysis rates and permitted consistently good results in cooperative patients. [17] (10.1016/j.hcl.2013.02.009)
  • [L1] These data implicate the A0 pulley as the primary cause of 31% to 47% of trigger fingers in this study. [18] (10.1177/1558944721994231)
  • [L5] The hand requires a stable wrist and at least two sensate digits that can oppose with some power for functional prehension. [20] (10.1016/s0749-0712(02)00130-0)
  • [L4] This case illustrates a patient with unilateral absence of the ring finger FDP musculotendinous structure, which can pose a diagnostic challenge when the history and examination suggest an acute avulsion of the ring finger FDP tendon. [23] (10.1016/j.jhsa.2016.02.003)
  • [Case_report] The patient regained nearly full extension of the affected fingers at 6 months and was able to return to work. [25] (10.1016/j.jhsa.2019.03.018)
  • [L5] Hand surgery and hand therapy practice interventions, including use of RMF orthoses for management of non-surgical and surgical EM injuries may benefit from an in-depth look at the EM zone III and IV anatomy and biomechanics. [26] (10.1016/j.jht.2023.01.002)
  • [L5] Understanding the dynamic and passive stabilizing mechanisms is essential for diagnosing imbalance and for planning reconstructive strategies that restore movement. [27] (10.1177/17531934261427638)
  • [L5] The findings from our study clarify hand surface landmarks in localizing the thumb A1 pulley and digital neurovascular structures. [28] (10.1016/j.jhsa.2013.02.028)
  • [L5] The relative motion concept harnesses normal functional anatomic relationships of the EDC and FDP muscles to vary forces on finger joints, allowing immediate controlled active motion while reducing undesirable tension. [29] (10.1016/j.jht.2022.12.006)
  • [L5] Relative motion between a tendon and SSCT in the carpal tunnel is maximal at extremes of wrist motion, particularly 60° extension, which may predispose the SSCT to shear injury. [32] (10.1016/j.jhsa.2008.09.021)
  • [L4] The active finger protocol was found to require the strongest tension of the tendon and with the longest excursion. [33] (10.1016/j.jht.2021.01.006)
  • [Case_report] Hand surgeons should be aware that injury to the extensor mechanism and specifically the central slip can lead to snapping or catching at the PIP joint in the finger. [35] (10.1177/15589447221081876)
  • [L5] A1 pulley confluence varies on a digit-to-digit basis, with no observed confluence in the thumb and the most common confluence observed in the middle finger. [36] (10.1016/j.jhsa.2022.02.011)
  • [L3] Clinical examination can be a valuable tool for detecting flexor disease in view of its high specificity and positive predictive values, but a negative clinical examination does not exclude inflammation and an US should be considered. [37] (10.1186/1471-2474-12-91)

References

[1] Sonographic Appearance of the Flexor Tendon, Volar Plate, and A1 Pulley With Respect to the Severity of Trigger Finger. The Journal of Hand Surgery. 2012. DOI: 10.1016/j.jhsa.2012.06.027 [2] Flexor Tendon Sheath Ganglions: Results of Surgical Excision. HAND. 2007. DOI: 10.1007/s11552-007-9028-4 [3] Tenosynovitis of the extensor pollicis longus tendon caused by an intratendinous ganglion: a case report. Journal of Hand Surgery (European Volume). 2012. DOI: 10.1177/1753193412453428 [4] Outcomes of Wide-Awake Flexor Tendon Repairs in 58 Fingers and 9 Thumbs. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2022.01.015 [5] Flexor digitorum profundus with or without flexor digitorum superficialis tendon repair in acute Zone 2B injuries. Journal of Hand Surgery (European Volume). 2020. DOI: 10.1177/1753193420932446 [6] Adhesions as a component of the trigger finger: a dynamic sonographic study. Journal of Hand Surgery (European Volume). 2020. DOI: 10.1177/1753193420969293 [7] Flexor Tendon Sheath Infections of the Hand. Journal of the American Academy of Orthopaedic Surgeons. 2012. DOI: 10.5435/jaaos-20-06-373 [8] Finger flexor tendon injuries repaired surgically followed by an early active motion program: A prospective cohort study of clinician- and patient-reported outcomes. Journal of Hand Therapy. 2026. DOI: 10.1016/j.jht.2024.12.011 [9] Tendinopathies of the Hand and Wrist. Journal of the American Academy of Orthopaedic Surgeons. 2015. DOI: 10.5435/jaaos-d-14-00216 [10] Volar wrist ganglion presenting as trigger finger. Journal of Hand Surgery (European Volume). 2012. DOI: 10.1177/1753193412453699 [11] Ganglion cysts and other tumor related conditions of the hand and wrist. Hand Clinics. 2004. DOI: 10.1016/j.hcl.2004.03.015 [12] Six-Strand Flexor Pollicis Longus Tendon Repairs With and Without Circumferential Sutures: A Multicenter Study. HAND. 2022. DOI: 10.1177/15589447211057295 [13] Accuracy and Safety of Non-Image Guided Trigger Finger Injections: A Cadaveric Study. HAND. 2022. DOI: 10.1177/15589447221093676 [15] A technique for accurately marking the A1 pulley on the skin. Journal of Hand Surgery (European Volume). 2012. DOI: 10.1177/1753193411436294 [17] Wide-awake Flexor Tendon Repair and Early Tendon Mobilization in Zones 1 and 2. Hand Clinics. 2013. DOI: 10.1016/j.hcl.2013.02.009 [18] Differential Pulley Release in Trigger Finger: A Prospective, Randomized Clinical Trial. HAND. 2021. DOI: 10.1177/1558944721994231 [20] Biomechanics and hand trauma: what you need. Hand Clinics. 2003. DOI: 10.1016/s0749-0712(02)00130-0 [23] Absent Ring Finger Flexor Digitorum Profundus Presenting as a Jersey Finger. The Journal of Hand Surgery. 2016. DOI: 10.1016/j.jhsa.2016.02.003 [25] Congenital Hypoplasia of the Extensor Tendons of the Fingers: A Case Report and Review of the Literature. The Journal of Hand Surgery. 2020. DOI: 10.1016/j.jhsa.2019.03.018 [26] An in-depth look at zone III and IV anatomy of the finger extensor mechanism and some clinical implications for use of the relative motion flexion orthosis. Journal of Hand Therapy. 2023. DOI: 10.1016/j.jht.2023.01.002 [27] The balanced finger: biomechanics of intrinsic and extrinsic systems and principles of reconstruction. Journal of Hand Surgery (European Volume). 2026. DOI: 10.1177/17531934261427638 [28] Hand Surface Landmarks and Measurements in the Treatment of Trigger Thumb. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2013.02.028 [29] A commentary from the pioneers on the innovation of the relative motion concept: History, biologic considerations, and anatomic rationale. Journal of Hand Therapy. 2023. DOI: 10.1016/j.jht.2022.12.006 [32] Shear Strain and Motion of the Subsynovial Connective Tissue and Median Nerve During Single-Digit Motion. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2008.09.021 [33] Ultrasonographic assessment in vivo of the excursion and tension of flexor digitorum profundus tendon on different rehabilitation protocols after tendon repair. Journal of Hand Therapy. 2022. DOI: 10.1016/j.jht.2021.01.006 [35] Longitudinal Tear of the Central Slip Causing Painful and Unusual Snapping of the Finger: A Case Report. HAND. 2022. DOI: 10.1177/15589447221081876 [36] Defining the Digit-Specific Confluence of the A1 Pulley. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2022.02.011 [37] A comparison of ultrasound and clinical examination in the detection of flexor tenosynovitis in early arthritis. BMC Musculoskeletal Disorders. 2011. DOI: 10.1186/1471-2474-12-91

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