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Trigger Finger Diabetes Complications

Musculoskeletal Manifestations Of Diabetes Mellitus

Musculoskeletal Manifestations Of Diabetes Mellitus

Introduction Diabetes mellitus affects nearly 387 million people worldwide. 1 The number of adults with diabetes in Europe is estimated to be over 50 million with a prevalence of 7.9%, and it is estimated that around 17.2 million people remain undiagnosed. Around 90% of patients with diabetes have Type 2 diabetes (T2D), characterized by variable degrees of insulin resistance and deficiency. Type 1 diabetes (T1D) is an autoimmune condition, characterized by the destruction of the insulin-producing beta cells, resulting in lifelong insulin deficiency. In developed countries, T1D is increasing at a rate of around 4% a year. 2 Whilst diabetes is widely recognized as causing significant morbidity and premature mortality due to myocardial infarction, stroke, renal failure, visual impairment and foot ulceration, it is less widely known that diabetes is associated with a number of musculoskeletal conditions. Patients with diabetes may develop several musculoskeletal syndromes or symptoms, many of which are associated with the severity and duration of the disease. These conditions may affect joints, soft tissues, nerves, muscles or tendons. Some conditions are unique to people with diabetes, while others are seen in the general population but have a higher prevalence in the diabetic population. While some of these conditions stem from other complications of diabetes, such as peripheral neuropathy, others seem to be directly caused by the metabolic abnormality, with direct glycosylation damaging tissues. Though musculoskeletal complications of diabetes are rarely life threatening, they usually occur in patients who have other complications, such as cardiovascular, neuropathic, nephropathic or retinal conditions, and can cause significant disability. This article aims to review so Continue reading >>

Aahs - Increased Rate Of Complications Following Trigger Finger Release In Diabetic Patients

Aahs - Increased Rate Of Complications Following Trigger Finger Release In Diabetic Patients

Increased Rate of Complications Following Trigger Finger Release in Diabetic Patients Andrew E. Federer, MD; Rita E. Baumgartner, MD; Daniel Cunningham, MD, MHSc; Marc Richard, MD; Suhail K. Mithani, MD Duke University Medical Center, Durham, NC Introduction: An increased rate of complications has been demonstrated in patients with diabetes for a variety of orthopaedic procedures, such as in arthroplasty and spine surgery. Current data regarding the impact of diabetes mellitus (DM) on complications after open trigger finger release (TFR) is conflicting. We investigated postoperative complications following TFR in patients with and without DM. Materials & Methods: A matched, case-control study was performed on all patients with DM that underwent TFR at a single academic institution within the past 10 years. Exclusion criteria were comorbid rheumatoid arthritis, malignancy, HIV/AIDS, connective tissue disorders, or systemic steroid use. One hundred forty-six diabetic patients were eligible for inclusion. These patients were then matched one-to-one to non-diabetic patients undergoing TFR based on age, sex, race, and BMI (normal, overweight, and grades 1-3 of obesity) during the same time period. Nine of 146 diabetic patients (6.2%) were unable to be matched due to their particular combination of BMI and race and were excluded. The remaining 137 patients (93.8%) were matched. The primary outcome measure was complications. Complications included superficial or deep infection, delayed wound healing, limited range of motion (ROM) at 6 weeks, pain requiring medication at 6 weeks, and return to operating room. Odds ratios with 95% confidence intervals (CI) were calculated to quantify the association of diabetes status with all-cause and specific complications. Results: Diabetic Continue reading >>

Stiff Hand Syndrome

Stiff Hand Syndrome

Tweet Diabetic stiff hand syndrome, also known as diabetic cheiroarthropathy, is a disorder in which finger movement becomes limited as the hands become waxy and thickened. Both people with type 1 diabetes and type 2 diabetes can be affected by diabetic stiff hand syndrome, but optimising glycemic control and physical therapy can slow down the development of the condition. Who is affected? Rachel Peterson Kim, MD et al report that diabetic stiff hand syndrome is found in eight to 50 per cent of patients with type 1 diabetes, but that type 2s can also develop the disorder. Prevalence is reportedly increased as patients have diabetes for longer, while it can also be more common in patients with diabetic neuropathy. Diabetic stiff hand syndrome is associated with being a predictor for other diabetes-related complications. Symptoms of diabetic stiff hand syndrome Diabetic stiff hand syndrome is characterised by the inability to strengthen joints in the hand. As a result, hand function can be severely limited. Affected patients find stiffness begins in the little finger and spreads to the thumb. Eventually, this stiffness can prevent people bringing all of the fingers together completely upon holding their palms together. Thick, tight, and waxy skin may also develop on the back of your hand as diabetic stiff hand syndrome develops. What causes diabetic stiff hand syndrome? Multiple factors are thought to be related to the underlying cause of diabetic stiff hand syndrome. Peterson et al report factors that can enhance development include when glycosylation - the process of sugar molecules attaching to protein molecules - is increased and causes additional collagen in the skin. Harry Belcher MS, FRCS also writes that changes to the composition of collagen which lead to abnorma Continue reading >>

Trigger Finger: Surgery & Treatment, Symptoms, And Causes

Trigger Finger: Surgery & Treatment, Symptoms, And Causes

How Long Does Recovery From Trigger Finger Take? Trigger finger is a painful condition that causes the fingers or thumb to catch or lock when bent. In the thumb its called trigger thumb. Trigger finger happens when tendons in the finger or thumb become inflamed. Tendons are tough bands of tissue that connect muscles and bones. Together, the tendons and muscles in the hands and arms bend and straighten the fingers and thumbs. A tendon usually glides easily through the tissue that covers it (called a sheath) because of a lubricating membrane surrounding the joint called the synovium. Sometimes a tendon may become inflamed and swollen. Prolonged irritation of the tendon sheath can produce scarring and thickening that impede the tendon's motion. When this happens, bending the finger or thumb can pull the inflamed tendon through a narrowed tendon sheath, making it snap or pop. Trigger finger can be caused by a repeated movement or forceful use of the finger or thumb. Rheumatoid arthritis , gout , and diabetes also can cause trigger finger. So can grasping something, such as a power tool, with a firm grip for a long time. Farmers, industrial workers, and musicians often get trigger finger since they repeat finger and thumb movements a lot. Even smokers can get trigger thumb from repeated use of a lighter, for example. Trigger finger is more common in women than men and tends to happen most often in people who are 40 to 60 years old. One of the first symptoms of trigger finger is soreness at the base of the finger or thumb. The most common symptom is a painful clicking or snapping when bending or straightening the finger. This catching sensation tends to get worse after resting the finger or thumb and loosens up with movement. In some cases, the finger or thumb locks in a ben Continue reading >>

Outcome Of Trigger Finger Treatment In Diabetes.

Outcome Of Trigger Finger Treatment In Diabetes.

Outcome of trigger finger treatment in diabetes. Hand Surgery Unit, Rambam Medical Center and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. Trigger finger is an underdiagnosed hand disorder causing disability in longstanding diabetic patients. Sixty diabetic patients [39 insulin-dependent diabetes mellitus (IDDM) and 21 non-insulin-dependent diabetes mellitus (NIDDM)] and 60 nondiabetic patients were examined. All were initially treated by steroid injections: failure to alleviate symptoms was the indication for surgery. The incidence of multiple digit involvement was higher in IDDM patients as compared with the control group (p < 0.001). The diffuse type was 1.45 times more frequent in IDDM and NIDDM than in nondiabetic patients (p < 0.008). The diabetic patients had a relatively longer duration of symptoms (p < 0.003). Significantly, a higher recovery rate upon steroid injection was achieved in control patients as compared with the diabetic ones (p < 0.001). IDDM patients required more surgery compared with NIDDMs and, in 13.3% of diabetic patients, the surgical outcome was not successful. Diabetic patients should be diagnosed early for multiple and diffuse types of trigger digits. Steroid injection as the first mode of therapy is highly recommended although not always successful. Surgery is the definitive treatment but requires a long course of physiotherapy and may be associated with some complications. Continue reading >>

Trigger Finger And Diabetes | Diabetic Connect

Trigger Finger And Diabetes | Diabetic Connect

The American Academy of Orthopaedic Surgeons has identified the following causes/ occurrences of trigger finger: Trigger finger happens most frequently in people who are 40 to 60 years old. Certain medical conditions are held in common with trigger finger, namely diabetes and rheumatoid arthritis. Symptoms may be preceded by activities that stress the hand. This is a condition thats more common in women than men. An unusual formation of a tender lump in the palm. Tightness that may stretch into the forearm. Pain with finger movement in both opening and closing. Popping, catching, ratcheting, and jerky finger movements. Non-surgical solutions vs. surgical solutions A diagnosis neednt involve x-rays or MRIs; a simple physical exam and a verbal description of symptoms will help guide a healthcare provider in identifying trigger finger as the cause of your limitations and pain. Non-surgical treatments may include medications such as ibuprofen and Tylenol, hand rest achieved by splinting of the finger, or a steroid injection. Diabetes may limit these options if you cant take anti-inflammatories or if you and your doctor dont prefer steroid injections due to their side effects, such as increasing blood sugar levels after administration. Your doctor will suggest a treatment plan thats appropriate for your particular medical needs. Surgery may be a solution, but it isnt without its risks. The procedure involves a small incision to the palm, which widens the tunnel that the tendon slides through. Results can be quite successful when its performed as an outpatient hospital procedure, especially when paired with physical therapy and finger exercises to regain flexion and extension of the affected finger. See your healthcare provider if you are experiencing any of these symptoms; Continue reading >>

Trigger Fingers - Diabetes Complications And Other Conditions - Tudiabetes Forum

Trigger Fingers - Diabetes Complications And Other Conditions - Tudiabetes Forum

Diabetes Complications and other Conditions Is anyone aware of any research being done on trigger fingers in diabetics? I never realized there was increased incidence with diabetes and hypothyroidism. (So, I get the double whammy!) I had my first trigger release done on the middle finger of my dominant hand in 2005. Immediately after surgery, I developed a trigger on the ring finger of the same hand. Frustrated at the surgeons response (Well, we can correct that for you, too!), I ignored it for years. Then the triggering affected my little finger as well. So I went be to a new surgeon, had the two releases done (2017), and within 2 weeks after the surgery, my index finger developed the trigger. Now its difficult to grasp anything in my dominant hand. Signing my signature is a ludicrous effort. I need to get it released, but fear that it will just move to my thumb. This jumping inflammation is disheartening. I had two trigger finger releases done by a great surgeon and I got 100% relief quite quickly and there have been no problems since then with those fingers and it has been quite a few years. The trick is to make sure you have a good surgeon I also over my 47 years have had many trigger finger releases done. I have had two fingers done twice. I also had carpal tunnel surgery on both hands. Was told these are very common with people who have diabetes. And was also told trigger finger can happen again in a finger that has already been done. One surgery, I had 3 fingers on one hand done at the same time. I have always said I dont have complications from my diabetes (eyes, nerves, heart, kidneys) but this has been with me since the early 80s and I currently have another repeat finger that needs surgery. I havent heard of anything that helps this problem, but I always hea Continue reading >>

Trigger Finger: A Complication Of Ra And Diabetes

Trigger Finger: A Complication Of Ra And Diabetes

What is trigger finger? Trigger finger (also called stenosing tenosynovitis or stenosing tendovaginitis) is a painful condition in which a finger or thumb becomes "locked" in place after it has been flexed. There may be clicking, popping, or a catching sensation in the affected finger, which becomes difficult to straighten without assistance. Some patients may experience stiffness and reduced motion without the characteristic catching or locking. Stenosing tendovaginitis (i.e., narrowing inflammation of the tendon sheath) can affect any of 23 extrinsic tendons that power the wrist and hand. However, trigger finger most commonly affects the little finger, ring finger, or thumb. Additional symptoms include a bump or lump (nodule) at the base of a finger near the palm, tenderness, or lingering soreness at the base of a finger or thumb. What causes trigger finger? Trigger finger is caused by inflammation and/or hypertrophy (enlargement) of the tendon sheath. This inflammation narrows the space in the tendon sheath, which acts like a tunnel through which the tendon glides, and progressively restricts the motion of the flexor tendon passing through the wrist or hand. A tendon is the strong tissue that attaches muscle to bone and helps us move parts of our body. When a muscle in the forearm contracts and pulls on the tendon attached to a finger, it causes that finger to bend (flex). A tendon which travels through a narrowed sheath may be able to move in one direction but be unable to slide back into its original, neutral position. This causes the finger to remain in a flexed position. Who gets trigger finger? Although anyone can develop trigger finger, it occurs more frequently in women than men (4:1 ratio), especially in women over the age of 40, and in people diagnosed with Continue reading >>

What Are Potential Complications Of Trigger Finger (tf) Surgery?

What Are Potential Complications Of Trigger Finger (tf) Surgery?

What are potential complications of trigger finger (TF) surgery? If the surgeon maintains a careful surgical technique, the incidence of complications should be low. [ 70 ] Potential complications of TF surgery include the following: Tenderness over the site of the incision - This occurs quite frequently but usually settles on its own Adhesions and subsequent stiffness - This may develop with excessive handling of the tendon or delayed postoperative mobilization Digital nerve injury - Overall, this is extremely rare, even though the digital nerves lie within 2-3 mm of the midline; prompt repair or reconstruction is indicated in the event of this unfortunate complication; observation for suspected neurapraxia is appropriate; digital nerve transection is the most common complication reported after trigger thumb surgery; the radial digital nerve is injured more frequently because of its superficial location and oblique course over the flexor sheath Superficial scoring of the FDS tendon -This has been reported frequently but does not require further treatment Accidental cutting into the A2 pulley - This can cause bowstringing, with loss of full finger flexion; pulley exploration and reconstruction may be indicated if bowstringing does not resolve Scarring - This is more likely to occur after TF surgery than after trigger thumb surgery Recurrence - This has been reported but is extremely rare Infection - This is a risk in patients who are diabetic or immunosuppressed and may be problematic if septic flexor tenosynovitis results Research has shown no statistically significant differences in surgical complication rates between persons with diabetes and those without it. This was also found to be true when patients with type 1 diabetes were compared with individuals who had ty Continue reading >>

Diabetes And Your Hands

Diabetes And Your Hands

Did you know that diabetes can hurt, stiffen, and even disable your shoulders, wrists, fingers, and other joints? None of these conditions is well understood. So how can you prevent them and deal with them? Of course, people without diabetes can have joint issues, but having diabetes raises your risk. All of these conditions seem to be related to thickening or stiffening of connective tissues — the ligaments and tendons that hold our bodies together. These tissues are mostly made of collagen, a protein that should have some give and flow to it, like a soft rubber ball. When collagen stiffens, joints start to hurt and don’t work as well. Here are four of the more well known diabetes-related joint conditions: Frozen shoulder, also known as adhesive capsulitis, is a condition in which the range of motion of the shoulder joint is severely restricted. According to the American Diabetes Association, it affects 20% of people with diabetes and 5% of the general population. It usually starts with shoulder pain and inflammation and can progress to stiffness and near-complete immobility. Then it starts to resolve, and is usually gone within two years, especially with treatment. Diabetic stiff hand syndrome is a painless disorder caused by an increase in collagen in and just below the skin. It can sharply limit hand function. Carpal tunnel syndrome (CTS) is a painful condition caused by pressure on the median nerve, which passes into the hand through a narrow “tunnel.” If this tunnel is squeezed by thickening of ligaments or other structures, severe pain can result. CTS is often associated with typing or other repetitive work that keep wrists in unnatural positions. Trigger finger is a condition where one or more fingers curl up and are difficult to straighten. The tendons Continue reading >>

Trigger Finger Surgery: Recovery, Procedure, And More

Trigger Finger Surgery: Recovery, Procedure, And More

If you have trigger finger , also known as stenosing tenosynovitis, youre familiar with the pain from having a finger or thumb stuck in a curled position. It can hurt whether or not youre using your hand. Plus, theres the frustration of not being able to do the things you want to, from buttoning your clothes to texting to playing guitar, or maybe even playing a video game. Surgery for trigger finger is done to increase the space for your flexor tendon to move. Your flexor tendon is a tendon in your fingers that is activated by your muscles to pull on the finger bones. That allows your finger to bend and flex. After surgery, the finger can bend and straighten without pain. Your doctor may recommend surgery if youre healthy and have tried other treatments without success, or if your symptoms are severe. resting the hand for three to four weeks by not doing activities that require repetitive motion wearing a splint at night for up to six weeks to keep the affected finger straight while you sleep taking over-the-counter nonsteroidal anti-inflammatory medicines, including ibuprofen (Advil, Motrin IB) or naproxen (Aleve), to ease pain (though they wont likely decrease swelling) one or two steroid (glucocorticoid) injections near or into the tendon sheath to reduce inflammation Steroid injections are the most common treatment. Theyre effective for up to 90 percent of people who dont have diabetes. This treatment is less effective in people with both diabetes and trigger finger. Your doctor may recommend surgery sooner if you have diabetes or have severe symptoms, such as: restricted finger or hand movement thats bothersome or disabling painful fingers, thumbs, hands, or forearms the inability to do daily tasks without them being awkward or painful, including work, hobbies, or Continue reading >>

Trigger Digits And Diabetes Mellitus

Trigger Digits And Diabetes Mellitus

We are experimenting with display styles that make it easier to read articles in PMC. The ePub format uses eBook readers, which have several "ease of reading" features already built in. The ePub format is best viewed in the iBooks reader. You may notice problems with the display of certain parts of an article in other eReaders. Generating an ePub file may take a long time, please be patient. The problem of finger in the patient with diabetes mellitus is important consideration in diabetology. Generally, peripheral neuropathy that manifests with finger paresthesia is common. However, some recent reports mention the concern on trigger digits in diabetic patients. In this brief article, the authors focus review and discussion on this specific topic. The searching of standard database, PubMed, on available publication on this area selecting by keywords trigger digits and diabetes mellitus was done and all derived papers were extracted and further synthesized in this review article. Epidemiology and management of the condition are the mainly focused reviewed areas and presented in this article. Keywords: Diabetes mellitus, Problem, Trigger digits The problem of finger in the patient with diabetes mellitus is important consideration in diabetology. Generally, peripheral neuropathy that manifests with finger paresthesia, numbness, and blanching is common.[ 1 ] The symptoms are usually bilateral.[ 1 ] Nerve conduction studies, vibration and temperature threshold measurements, and neurovascular function tests are useful for assessment of these cases.[ 2 ] However, some recent reports mention the concern on trigger digits in diabetic patients. In this brief article, the authors focus review and discussion on this specific topic. Epidemiology of Trigger Digits in Diabetic Patient Continue reading >>

Hand Disorders Associated With Diabetes: A Review | Zyluk | Acta Orthopaedica Belgica

Hand Disorders Associated With Diabetes: A Review | Zyluk | Acta Orthopaedica Belgica

Hand disorders associated with diabetes: a review The diabetes may cause damage many structures and organs of a human body and predispose to secondary disorders, including involvement of the hand. Carpal tunnel syndrome, trigger finger or Dupuytrens disease occur more frequently in diabetic patients as well as other, poorer recognized conditions such as limited joint mobility, or hand weakness. The paper presents these disorders, emphasizes differences in clinical presentation, methods and outcomes of treatment, comparing to the non-diabetic patients. Although there are not call complications, some evidence suggests that they may be, as their prevalence is related to the duration of the diabetes, poor metabolic control and occurrence of other disorders such as retino- and nephropathy. Diabetes complications; Carpal tunnel syndrome; Trigger finger Abate M, Schiavone C, Salini V et al. Management of limited joint mobility in diabetic patients. Diabetes Metab Syndr Obes 2013; 7: 197-207. Catalano LW, Glickel SZ, Barron OA et al. Effect of local corticosteroid injection of the hand and wrist on blood glucose in patients with diabetes mellitus. Orthopedics 2012; 35: 1754-1758. Crispin JC, Alcocer-Varela J. Rheumatiologic manifestations of diabetes mellitus. Am J Med 2003; 114: 753-757. Fitzgibbons PG, Weiss AP. Hand manifestations of diabetes mellitus. J Hand Surg 2008; 33-A: 771-775. Gill G, Famuyiwa OO, Rolfe et al. Tropical diabetic hand syndrome. Lancet 1998, 352: 113-114. Hart MG, Hooper G. Clinical associations of Dupuytrens disease. Postgrad Med J 2005; 81: 425-428. Lawson PM, Maneschi F, Kohner EM. The relationship of hand abnormalities to diabetes and diabetic retinopathy. Diabet Care 1983; 6: 140-143. Loos B, Puschkin V, Horch RE. 50 years experience with Dupuytre Continue reading >>

Diabetes And Trigger Finger

Diabetes And Trigger Finger

Diabetes is a chronic condition that increases the risk for serious health problems for those saddled with the disease. Among the most common complications connected to diabetes are cardiovascular disease, neuropathy, retinopathy, and depression. One of the lesser known conditions is trigger finger or stenosing tenosynovitis. Trigger finger is a musculoskeletal ailment that affects the ligaments and tendons in the hand. Those dealing with this condition have a finger or thumb that gets stuck in a bent position, then the digit straightens with a snap, not unlike a trigger being pulled then released. Trigger finger is more common in women than men and occurs most often in people between the ages of 40 and 60. The condition occurs when theres an overgrowth or swelling of tissue in the tendon sheath of the flexor muscles. When the tendon can no longer glide smoothly through the sheath, it catches and remains bent. It releases with a painful click as it straightens. The cause of trigger finger is unknown, but there are a number of factors that increase the likelihood of developing the condition. One of those factors is diabetes. Trigger finger gets lumped with other diabetes-related joint conditions, including frozen shoulder, diabetic stiff hand syndrome,and carpal tunnel syndrome. Trigger finger is a fairly common complication of diabetes, particularly in long-standing diabetes. Its thought that chronically elevated blood glucose levels cause the connective tissue to become glycated, which means an irreversible bond between glucose and protein forms in the tissue which damages it. This condition affects 2 to 3 percent of the general population, but 10 to 20 percent of those with diabetes. Treatment for this condition varies depending on its severity. Anti-inflammatory dru Continue reading >>

Trigger Finger - Diabetes Self-management

Trigger Finger - Diabetes Self-management

A painful condition that causes catching or locking of a finger as it is extended. Trigger finger is due to overgrowth of tissue in the tendon sheath (the protective membrane) of the flexor muscles, the muscles that ordinarily allow fingers to curl. Also called flexor tenosynovitis, trigger finger is a fairly common complication of diabetes, especially long-standing diabetes. It is thought that chronically elevated blood glucose levels cause the connective tissue to become glycated, meaning that irreversible bonds between glucose and proteins form in the tissue, damaging it. Trigger finger is initially treated by injecting corticosteroids into the flexor tendon sheath. If this fails to completely alleviate the problem, minor surgery may be needed to provide permanent relief. This column is written by Robert Dinsmoor, a Contributing Editor of Diabetes Self-Management. Disclaimer Statements: Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information. Continue reading >>

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