Overview

4.3 out of 5 (11 Reviews)

Credits

1.00

Post Assessment Questions

5

Start Date

1 Jan 2021

Last Review Date

5 Feb 2024

Expiration Date

31 Dec 2023

Estimated Time To Finish

60 Minutes


 
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Activity Description

Trigger thumb or stenosing flexor tenosynovitis of the thumb is characterized by a narrowing of the flexor tendon sheath. This constriction results in the flexor tendon catching as it attempts to glide smoothly through the relatively stenotic sheath. Trigger thumb or trigger finger is caused by a size mismatch of the diameter between the swollen flexor tendon and its sheath at the level of the metacarpal head. The outcome is a noticeable clicking or popping sensation during attempts at thumb extension. Both the extrinsic flexor pollicis longus (FPL) and intrinsic flexor pollicis brevis (FPB) contribute to the flexion process. The FPL tendon travels within its sheath, passing through the A1, oblique, and A2 pulleys, with the A1 pulley positioned most proximally and the A2 pulley situated most distally. Notably, the A1 pulley overlaps the metacarpal bone, overlapping the metacarpophalangeal joint and the base of the proximal phalanx.

Trigger thumb typically results from the thickening of the A1 pulley, leading to pain and reduced functionality. Both adults and children can encounter trigger thumb. Although trigger thumb are predominantly acquired in adults, they are regarded as a rare developmental anomaly in children. Treatment for this condition commences with splinting and physical therapy. Intralesional steroid injections are suitable for patients unresponsive to conservative management. In cases where conservative measures prove insufficient, surgical release of the A1 pulley may be necessary to manage the condition effectively. This activity comprehensively reviews the etiology, diagnosis, evaluation, and management of trigger thumb while highlighting the crucial role of interprofessional healthcare teams in fostering collaboration to deliver well-coordinated care to patients with this condition.


Target Audience

This activity has been designed to meet the educational needs of physicians.

Learning Objectives

At the conclusion of this activity, the learner will be better able to:

  • Identify the clinical manifestations and characteristic clicking or popping sensation associated with trigger thumb during thumb extension.

  • Differentiate between trigger thumb and other conditions causing thumb dysfunction, considering both adult-acquired and pediatric presentations.

  • Apply conservative management strategies, including splinting and physical therapy, as initial interventions for trigger thumb, considering the patient's age and severity of symptoms.

  • Coordinate care seamlessly by collaborating with interprofessional healthcare teams, involving early assessment, timely intervention, and follow-up to optimize long-term outcomes for patients with trigger thumb.

Disclosures

The Campbell University Jerry M. Wallace School of Osteopathic Medicine (CUSOM) requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they or their immediate family may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by CUSOM for resolution, to ensure fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

CUSOM will identify, review, and resolve all conflicts of interest that faculty, authors, activity directors, planners, managers, peer reviewers, or relevant staff disclose prior to an educational activity being delivered to learners. Disclosure of a relationship is not intended to suggest or condone bias in any presentation but is made to provide participants with information that might be of potential importance to their evaluation of a presentation. Disclosure information for authors, editors, planners, peer reviewers, and/or relevant staff is provided with this activity.

Continuing Education Accreditation Information

 

 

The Campbell University Jerry M. Wallace School of Osteopathic Medicine (CUSOM) is accredited by the American Osteopathic Association to provide osteopathic continuing medical education for physicians. CUSOM designates this enduring material for a maximum of 1.00 AOA Category 1 B Credits and will report CME credits commensurate with the extent of the physician's participation in the activity.

Cancellation Policy: Cancellations must be received in writing and a money back guarantee is provided if not completely satisfied.

  • StatPearls and CUSOM reserve the right to cancel any course due to unforeseen circumstances. StatPearls and CUSOM will not be responsible for other expenses incurred by the participant in the unlikely event that the program is canceled.

Equal Opportunity

  • StatPearls and CUSOM are Equal Opportunity / Affirmative Action / Equal Access Institutions. 

Medium or Media Used:

  • Computer Requirements:  Internet Access
  • E-mail Address

Instructions for Credit

  1. Register for the activity and create a StatPearls login.     
  2. Review the required accreditation information:  Target audience, learning objectives and disclosure information.
  3. Complete the entire self-study activity.
  4. Complete the post-test assessments.
  5. Successfully pass the post-test with a minimum score of 100%.
  6. Complete the evaluation form.
  7. Obtain a certificate.

StatPearls and CUSOM adheres to AOA Standards regarding commercial support of continuing medical education. It is the policy of StatPearls and Campbell that the faculty and planning committee disclose real or apparent conflicts of interest relating to the topics of this educational activity, that relevant conflict(s) of interest are resolved and also that authors and editors will disclose any unlabeled/unapproved use of drug(s) or device(s) during their presentation. Detailed disclosure will be made prior to starting the activity.

The information provided at this CME/CE activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

This course is intended for osteopathic physicians who wish to earn AOA CME credit. Take this version of the course to ensure you receive appropriate credit.

 

 
 

Reviews

Bonnie R. on 6/16/2021

Howard S. on 9/11/2021

Stephanie K. on 11/16/2021

Brandi F. on 2/28/2022

Ryan L. on 4/6/2022

Bonnie R. on 6/23/2022

Lisa R. on 9/25/2022

Daniel R. on 12/22/2022

Schuyler H. on 5/22/2023

Sadie H. on 8/21/2023

Denise W. on 10/22/2023

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