Trigger finger : its cause and mechanism / by Adoniram B. Judson.

  • Judson, Adoniram Brown, 1837-1916.
Date:
1914
Catalogue details

Licence: In copyright

Credit: Trigger finger : its cause and mechanism / by Adoniram B. Judson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    irregularities in other parts of the body where joint surfaces are held in contact by the static re- sistance of circumarticular ligaments and to some degree by the dynamic influence of muscular con- traction. No joints, however, but those of the digits are subject to the exceptionally great pres- sure of powerful muscles acting through tendons lying parallel to, and in close, contact with, long bones. The strength of these muscles is shown by the unyielding grip exhibited by the hand in an emergency. It is clear that when digital muscles are in action they concentrate on small articular surfaces pressure as positive and distinct as that made by the steel spring of the pocket knife. After witnessing the dissection of a normal hand, by the kindness of Dr. Gallaudet, it appeared to me that the node seen in the accompanying photograph of the affected hand, on the radial side of the base of the second phalanx of the middle finger, might extend into the joint where it would project as an obstacle on the palmar edge of the articular surface at the base of the phalanx. At this point it would be in apposition, when the joint is at a right angle, with the rounded lateral articulating condyle on the radial side of the head of the proximal phalanx. It is evident that when these two eminences, one ab- normal and the other normal, pass each other, as they do when the joint traverses the right angle, they must, when pressed together by muscular con- traction, experience a momentary hesitation fol- lowed by an acceleration of speed such as is seen in trigger finger. That there may be cases which do not have their origin in arthritis is suggested by the personal experiences and research of my friends, Drs. Weir and Abbe. It is surmised that as the flexors are stronger