Dr. Vincent K. McInerney

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• Shoulder

  Shoulder Anatomy The shoulder is the most flexible joint in the body enabling a wide range of movements including, forward flexion, abduction, adduction, external rotation, internal rotation, and 360-degree circumduction. Thus, the shoulder joint is considered the most insecure joint of the body but the support of ligaments, muscles and tendons function to provide the required stability. Bones of the Shoulder The shoulder is a ball and socket joint made up of three bones, namely the humerus, scapula, and clavicle. The end of the humerus or upper arm bone forms the ball of the shoulder joint. An irregular shallow cavity in the scapula called the glenoid cavity forms the socket for the head of the humerus to fit in. The two bones together form the glenohumeral joint, which is the main joint of the shoulder. The scapula is a flat triangular shaped bone that forms the shoulder blade. It serves as the site of attachment for most of the muscles that provide movement and stability to the joint. The scapula has four bony processes - acromion, spine, coracoid and glenoid cavity. The Acromion and coracoid process serve as places for attachment of the ligaments and tendons. The clavicle bone or collarbone is an S-shaped bone that connects the scapula to the sternum or breastbone. It forms two joints: the acromioclavicular joint, where it articulates with the acromion process of the scapula, and the sternoclavicular joint where it articulates with the sternum or breast bone. The clavicle also forms a protective covering for important nerves and blood vessels that pass under it from the spine to the arms. Sof t Tissues of the Shoulder The ends of all articulating bones are covered by smooth tissue called articular cartilage which allows the bones to slide over each other without friction enabling smooth movement. Articular cartilage reduces pressure and acts as a shock absorber during movement of the shoulder bones. Extra stability to the glenohumeral joint is provided by the glenoid labrum, a ring of fibrous cartilage that surrounds the glenoid cavity. The glenoid labrum increases the depth and surface area of the glenoid cavity to provide a more secure fit for the half-spherical head of the humerus. Ligaments of the Shoulder Ligaments are the thick strands of fibers that connect one bone to another. The ligaments of the shoulder joint include Coraco-clavicular ligaments: these ligaments connect the collarbone to the shoulder blade at the coracoid process Acromio-clavicular ligament: this connects the collarbone to the shoulder blade at the acromion process Coraco-acromial ligament: It connects the acromion process to the coracoid process Glenohumeral ligaments: A group of 3 ligaments that form a capsule around the shoulder joint, and connect the head of the arm bone to the glenoid cavity of the shoulder blade. The capsule forms a water-tight sac around the joint. Glenohumeral ligaments play a very important role in providing stability to the otherwise unstable shoulder joint by preventing dislocation. Muscles of the Shoulder The rotator cuff is the main group of muscles in the shoulder joint and is comprised of 4 muscles. The rotator cuff forms a sleeve around the humeral head and glenoid cavity, providing additional stability to the shoulder joint while enabling a wide range of mobility. The deltoid muscle forms the outer layer of the rotator cuff and is the largest and strongest muscle of the shoulder joint. Tendons of the Shoulder Tendons are strong tissues that join muscle to bone allowing the muscle to control the movement of the bone or joint. Two important group of tendons in the shoulder joint are the biceps tendons and rotator cuff tendons. Bicep tendons are the two tendons that join the bicep muscle of the upper arm to the shoulder. They are referred to as the long head and short head of the bicep. Rotator cuff tendons are a group of four tendons that join the head of the humerus to the deeper muscles of the rotator cuff. These tendons provide more stability and mobility to the shoulder joint. Nerves of the Shoulder Nerves carry messages from the brain to muscles to direct movement (motor nerves) and send information about different sensations such as touch, temperature and pain from the muscles back to the brain (sensory nerves). The nerves of the arm pass through the shoulder joint from the neck. These nerves form a bundle at the region of the shoulder called the brachial plexus. The main nerves of the brachial plexus are the musculocutaneous, axillary, radial, ulnar and median nerves. Blood Vessels of the Shoulder Blood vessels travel along with the nerves to supply blood to the arms. Oxygenated blood is supplied to the shoulder region by the subclavian artery that runs below the collarbone. As it enters the region of the armpit, it is called the axillary artery and further down the arm, it is called the brachial artery.

  Link: Shoulder

• Elbow

  Elbow Anatomy The elbow is a complex joint formed by the articulation of three bones -the humerus, radius and ulna. The elbow joint helps in bending or straightening of the arm to 180 degrees and assists in lifting or moving objects. The bones of the elbow are supported by Ligaments and tendons Muscles Nerves Blood vessels Bones and Joints of the Elbow The elbow joint is formed at the junction of three bones: The humerus (upper arm bone) forms the upper portion of the joint. The lower end of the humerus divides in to two bony protrusions known as the medial and lateral epicondyles which can be felt on either side of the elbow joint. The ulna is the larger bone of the forearm located on the inner surface of the joint. The curved shape of the ulna articulates with the humerus. The radius is the smaller bone of the forearm situated on the outer surface of the joint. The head of the radius is circular and hollow which allows movement with the humerus. The connection between the ulna and radius helps the forearm to rotate. The elbow consists of three joints from articulation of the three bones namely: Humero-ulnar joint is formed between the humerus and ulna and allows flexion and extension of the arm. Humero-radial joint is formed between the radius and humerus, and allows movements like flexion, extension, supination and pronation. Radio-ulnar joint is formed between ulna and radius bones, and allows rotation of the lower arm. Articular cartilage lines the articulating regions of the humerus, radius and ulna. It is a thin, tough, flexible, and slippery surface that acts as a shock absorber and cushion to reduce friction between the bones. The cartilage is lubricated by synovial fluid, which further enables the smooth movement of the bones. Muscles of the Elbow Joint There are several muscles extending across the elbow joint that help in various movements. These include the following: Biceps brachii: upper arm muscle enabling flexion of the arm Triceps brachii: muscle in the back of the upper arm that extends the arm and fixes the elbow during fine movements Brachialis: upper arm muscle beneath the biceps which flexes the elbow towards the body Brachioradialis: forearm muscle that flexes, straightens and pulls the arm at the elbow Pronator teres: this muscle extends from the humeral head, across the elbow, and towards the ulna, and helps to turn the palm facing backward Extensor carpi radialis brevis: forearm muscle that helps in movement of the hand Extensor digitorum: forearm muscle that helps in movement of the fingers Elbow Joint Ligaments and Tendons The elbow joint is supported by ligaments and tendons, which provide stability to the joint. Ligaments are a group of firm tissues that connect bones to other bones. The most important ligaments of the elbow joint are the: Medial or ulnar collateral ligament: comprised of triangular bands of tissue on the inner side of the elbow joint. Lateral or radial collateral ligament: a thin band of tissue on the outer side of the elbow joint. Together, the medial and lateral ligaments are the main source of stability and hold the humerus and ulna tightly in place during movement of the arm. Annular ligament: These are a group of fibers that surrounds the radial head, and holds the ulna and radius tightly in place during movement of the arm. The ligaments around a joint combine to form a joint capsule that contains synovial fluid. Any injury to these ligaments can lead to instability of the elbow joint. Tendons are bands of connective tissue fibers that connect muscle to bone. The various tendons which surround the elbow joint include: Biceps tendon: attaches the biceps muscle to the radius, allowing the elbow to bend Triceps tendon: attaches the triceps muscle to the ulna, allowing the elbow to straighten Nerves of the Elbow Joint The main nerves of the elbow joint are the ulnar, radial and median nerves. These nerves transfer signals from the brain to the muscles that aid in elbow movements. They also carry the sensory signals like touch, pain, and temperature back to the brain. Any injury or damage to these nerves causes pain, weakness or joint instability. Blood Vessels of the Elbow Joint Arteries are blood vessels that carry oxygen-pure blood from the heart to the hand. The main artery of the elbow is the brachial artery that travels across the inside of the elbow and divides into two small branches below the elbow to form the ulnar and the radial artery.

  Link: Elbow

• Hip

  Hip anatomy The hip joint is the largest weight-bearing joint in the human body. It is also referred to as a ball and socket joint and is surrounded by muscles, ligaments, and tendons. The thighbone or femur and the pelvis join to form the hip joint. Any injury or disease of the hip will adversely affect the joint's range of motion and ability to bear weight. The hip joint is made up of the following: Bones and joints Ligaments of the joint capsule Muscles and tendons Nerves and blood vessels that supply the bones and muscles of the hip Bones and Joints of the Hip The hip joint is the junction where the hip joins the leg to the trunk of the body. It is comprised of two bones: the thighbone or femur and the pelvis which is made up of three bones called ilium, ischium, and pubis. The ball of the hip joint is made by the femoral head while the socket is formed by the acetabulum. The acetabulum is a deep, circular socket formed on the outer edge of the pelvis by the union of three bones: ilium, ischium and pubis. The lower part of the ilium is attached by the pubis, while the ischium is considerably behind the pubis. The stability of the hip is provided by the joint capsule or acetabulum and the muscles and ligaments which surround and support the hip joint. The head of the femur rotates and glides within the acetabulum. A fibrocartilaginous lining called the labrum is attached to the acetabulum and further increases the depth of the socket. The femur or thighbone is one of the longest bones in the human body. The upper part of the thighbone consists of the femoral head, femoral neck, and greater and lesser trochanters. The head of the femur joins the pelvis (acetabulum) to form the hip joint. Next to the femoral neck , there are two protrusions known as greater and lesser trochanters , which serve as sites of muscle attachment. Articular Cartilage of the Hip Joint Articular cartilage is the thin, tough, flexible, and slippery surface lubricated by synovial fluid that covers the weight-bearing bones of the body. It enables smooth movements of the bones and reduces friction. Ligaments of the Hip Joint Ligaments are fibrous structures that connect bones to other bones. The hip joint is encircled with ligaments to provide stability to the hip by forming a dense and fibrous structure around the joint capsule. The ligaments adjoining the hip joint include: Iliof emoral ligament: This is a Y-shaped ligament that connects the pelvis to the femoral head at the front of the joint. It helps in limiting over-extension of the hip. Pubof emoral ligament: This is a triangular shaped ligament that extends between the upper portion of the pubis and the iliof emoral ligament. It attaches the pubis to the femoral head. Ischiof emoral ligament: This is a group of strong fibers that arise from the ischium behind the acetabulum and merge with the fibers of the joint capsule. Ligamentum teres: This is a small ligament that extends from the tip of the femoral head to the acetabulum. Although it has no role in hip movement, it does have a small artery within that supplies blood to a part of the femoral head. Acetabular labrum: The labrum is a fibrous cartilage ring which lines the acetabular socket. It deepens the cavity increasing the stability and strength of the hip joint. Muscles and Tendons of the Hip Joint A long tendon called the iliotibial band runs along the femur from the hip to the knee and serves as an attachment site for several hip muscles including the following: Gluteals: These are the muscles that form the buttocks. There are three muscles (gluteus minimus, gluteus maximus, and gluteus medius) that attach to the back of the pelvis and insert into the greater trochanter of the femur. Adductors: These muscles are in the thigh which help in adduction, the action of pulling the leg back towards the midline. Iliopsoas: This muscle is in front of the hip joint and provides flexion. It is a deep muscle that originates from the lower back and pelvis, and extends up to the inside surface of the upper part of the femur. Rectus femoris: This is the largest band of muscles located in front of the thigh. They also are hip flexors. Hamstring muscles: These begin at the bottom of the pelvis and run down the back of the thigh. Because they cross the back of the hip joint, they help in extension of the hip by pulling it backwards. Nerves and Arteries of the Hip Joint Nerves of the hip transfer signals from the brain to the muscles to aid in hip movement. They also carry the sensory signals such as touch, pain, and temperature back to the brain. The main nerves in the hip region include the femoral nerve in the front of the femur and the sciatic nerve at the back. The hip is also supplied by a smaller nerve known as the obturator nerve.

  Link: Hip

• Knee

  Knee Anatomy The knee is a complex joint made up of different structures including bones, tendons, ligaments and muscles. They all work together to maintain normal function and provide stability to the knee during movement. Having a well-functioning healthy knee is essential for our mobility and ability to participate in various activities. Understanding the anatomy of the knee enhances your ability to discuss and choose the right treatment procedure for knee problems with your doctor. Bones of the Knee The knee is a hinge joint made up of two bones, the thighbone (femur) and the shinbone (tibia). There are two round knobs at the end of the femur called femoral condyles which articulate with the flat surface of the tibia called the tibial plateau. The tibia plateau on the inside of the leg is called the medial tibial plateau, and on the outside of the leg it is called the lateral tibial plateau. The two femoral condyles form a groove on the front (anterior) side of the knee called the Patellofemoral groove. A small bone called the patella sits in this groove and forms the knee cap. It acts as a shield and protects the knee joint from direct trauma. A fourth bone called the fibula is the other bone of the lower leg. This form a small joint with the tibia. This joint has very little movement and is not considered a part of the main joint of the knee. Articular Cartilage and Menisci of the Knee Movement of the bones causes friction between the articulating surfaces. To reduce this friction, all articulating surfaces involved in movement are covered with a white, shiny, slippery layer called articular cartilage. The articulating surface of the femoral condyles, tibial plateaus and the back of the patella are covered with this cartilage. The cartilage provides a smooth surface that facilitates easy movement. To further reduce friction between the articulating surfaces of the bones, the knee joint is lined by a synovial membrane which produces a thick clear fluid called synovial fluid. This fluid lubricates and nourishes the cartilage and bones inside the joint capsule. Within the knee joint between the femur and tibia there are two C shaped cartilaginous structures called menisci. Menisci function to provide stability to the knee by spreading the weight of the upper body across the whole surface of the tibial plateau. The menisci help in load bearing by preventing the weight from concentrating onto a small area, which could damage the articular cartilage. The menisci also act as a cushion between the femur and tibia by absorbing the shock produced by activities such as walking, running and jumping. Ligaments of the Knee Ligaments are tough bands of tissue that connect one bone to another bone. The ligaments of the knee function to stabilize the knee joint. There are two important groups of ligaments that hold the bones of the knee joint together, collateral ligaments and the cruciate ligament. Collateral Ligaments of the Knee Collateral ligaments are present on either side of the knee. They function to prevent the knee from moving too far during side to side motion. The collateral ligament on the inside is called the medial collateral ligament (MCL) and the collateral ligament on the outside is called the lateral collateral ligament (LCL). Cruciate Ligaments of the Knee Cruciate ligaments present inside the knee joint, control the back and forth motion of the knee. The Cruciate ligament in the front of the knee is called anterior cruciate ligament or ACL and the cruciate ligament in the back of the knee is called posterior cruciate ligament or PCL. Muscles of the Knee There are two major muscles, the quadriceps and the hamstrings, which enable movement of the knee joint. The quadriceps muscles are in the front of the thigh. When the quadriceps muscles contract, the knee straightens. The hamstrings are in the back of the thigh. When the hamstring muscles contract, the knee bends. Tendons of the Knee Tendons are structures that attach muscles to the bone. The quadriceps muscles of the knee meet just above the patella and attach to it through a tendon called the quadriceps tendon. The patella further attaches to the tibia through a tendon called the patella tendon. The quadriceps muscle, quadriceps tendon and patellar tendon all work together to straighten the knee. Similarly, the hamstring muscles at the back of the leg are attached to the knee joint with the hamstring tendon.

  Link: Knee

• Spine

  Strains STRAINS Strains and sprains are the most common causes of neck and back pain. A strain refers to the stretching or tear of a muscle or tendon (tissue that connects muscles to bone). Strains can occur during sports injuries. accidents, heavy lifting or falling. Causes of Strains Strains often occur as a result of: Sudden jerking of the head, Excessive flexion (bending forward) Excessive extension (bending backward) Twisting Sudden contraction of a muscle or tendon Heavy lifting or improper lifting Falls Inadequate warm up before exercise Symptoms of Strains Symptoms of a strains include: Sharp pain in neck or back that may radiate to the shoulders, arms, buttocks or legs and is aggravated by movement Swelling Stiffness Muscle cramping or spasms Tenderness over the affected region Rarely, bowel or bladder dysfunction Diagnosis of Strains An accurate diagnosis and an effective treatment plan are required for a successful outcome. Your doctor will arrive at a diagnosis and determine the cause of pain based on your medical history and the physical and neurological examination findings. Your doctor will also test your reflexes, muscle strength, and sensory perception. Diagnostic imaging tests such as X-rays and MRI scans may be required to confirm the diagnosis and to rule out a spinal fracture. Electromyography (EMG) may also be done to reveal any muscle dysfunction. Treatment of Strains Strains are commonly managed with non-surgical treatment without the need for spinal surgery. The non-surgical treatment options include activity modification, ice application, anti-inflammatory and pain medications, muscle relaxants, bracing, physical therapy, chiropractic, and acupuncture. To enhance the success of your treatment, your doctor may combine two or more treatment modalities. Prevention of Strains Some of the preventive measures that can help prevent strains include: Maintenance of a healthy body weight A healthy well-balanced diet Regular stretching and strengthening exercises Proper lifting technique SPRAINS Strains and sprains are the most common causes of neck and back pain. A sprain refers to the stretching or tear of a ligament (tissue that connects adjacent bones). Sprains can occur during sports injuries. accidents, heavy lifting or falling. Causes of Sprains Sprains often occur as a result of: Excessive flexion (bending forward) Excessive extension (bending backward) Heavy lifting or improper lifting Falls Inadequate warm up before exercise Symptoms of Sprains Symptoms of a sprains include: Sharp pain in neck or back that may radiate to the shoulders, arms, buttocks or legs and is aggravated by movement Swelling Stiffness Muscle cramping or spasms Tenderness over the affected region Rarely, bowel or bladder dysfunction Diagnosis of Sprains An accurate diagnosis and an effective treatment plan are required for a successful outcome. Your doctor will arrive at a diagnosis and determine the cause of pain based on your medical history and the physical and neurological examination findings. Your doctor will also test your reflexes, muscle strength, and sensory perception. Diagnostic imaging tests such as X-rays and MRI scans may be required to confirm the diagnosis and to rule out a spinal fracture. Electromyography (EMG) may also be done to reveal any muscle dysfunction. Treatment of Sprains Sprains are commonly managed with non-surgical treatment without the need for spinal surgery. The non-surgical treatment options include activity modification, ice application, anti-inflammatory and pain medications, muscle relaxants, bracing, physical therapy, chiropractic, and acupuncture. To enhance the success of your treatment, your doctor may combine two or more treatment modalities. Prevention of Sprains Some of the preventive measures that can help prevent strains include: Maintenance of a healthy body weight A healthy well-balanced diet Regular stretching and strengthening exercises Proper lifting technique HERNIATED DISC What is a Herniated Disc? Herniated disc is a condition in which the outer layer (annulus) of the intervertebral disc are damaged causing the soft inner material of the nucleus pulposus to rupture out of its space. What Causes Herniated Discs? A herniated disc, common in the lower back (lumbar spine) occurs when there is a tear in the outer lining of the disc (annulus fibrosus). This causes the inner jelly-like material (nucleus pulposus) to leak out and place pressure on the adjacent spinal nerve root. It is the most common cause of low back pain and pain that radiates down the leg (radiculopathy). Symptoms Associated with Herniated Discs The most common signs and symptoms of lumbar disk herniation are back pain that radiates to buttocks and legs, numbness in the leg or foot, weakness in the leg or foot, and rarely loss of bowel and bladder control.

  Link: Spine

• Foot & Ankle

  Foot & Ankle Anatomy The foot and ankle form a complex joint involved in movement and providing stability and balance to the body. The foot and ankle consist of 26 bones, 33 joints, and many muscles, tendons and ligaments. Bones of the Ankle The ankle joint connects the leg with the foot, and is composed of three bones: tibia, fibula and talus. The tibia or shinbone and fibula or calf bone are bones of the lower leg which articulate with the talus or ankle bone, enabling up and down movement of the foot. Three bony bumps present on the ends of the tibia and fibula form parts of the ankle joint: The Medial malleolus, formed by the tibia, is found on the inside of the ankle; Posterior malleolus, also formed by the tibia, is found at the back of the ankle and the Lateral malleolus, formed by the fibula, is found on the outer aspect of the ankle Bones of the Feet The foot acts as a single functional unit but can be divided into three parts: the hindfoot, midfoot and forefoot. The hindfoot forms the ankle and heel and is made up of the talus bone and calcaneus or heel bone. The heel bone is the largest bone in the foot. The midfoot connects the hindfoot to the forefoot, and consists of one navicular bone, one cuboid bone, and three cuneiform bones. The navicular bone is found in front of the heel bone, and the cuneiform and cuboid bones are arranged in front of the navicular bone. These bones are connected to five metatarsal bones of the forefoot, which form the arch of the foot for shock absorption while walking or running. The forefoot is also made up of the toes or digits, formed by phalanges, three in each toe, except the big toe, which has only two phalanges. The big two has two additional tiny round sesamoid bones in the ball of the foot, which help in upward and downward movement of the toe. Ankle and Foot Joints There are 33 joints in the ankle and foot. They include the Hinge joints in the ankle, which allow flexion (bending) and extension Gliding joints found in the hindfoot, which allow gliding movements Condyloid joints found in the forefoot and toes, which allow the flexion (bending) and extension, adduction and abduction (sideward movement). The joints of the foot and ankle provide stability and support the weight of the body, helping you to walk or run, and to adapt to uneven ground. The joint surface of all bones of the ankle and foot are lined by a thin, tough, flexible, and slippery surface called articular cartilage, which acts as a shock absorber and cushion to reduce friction between the bones. The cartilage is lubricated by synovial fluid, which further enables smooth movement of the bones. Sof t Tissues of the Foot and Ankle Our feet and ankle bones are held in place and supported by various sof t tissues such as cartilage, ligaments, muscles, tendons and bursae . Cartilage in the Foot and Ankle Cartilage is the flexible, shiny, smooth tissue on the ends of bones that meet to form a joint. Cartilage provides cushioning between the bones allowing smooth movement. Ligaments in the Foot and Ankle Ligaments are tough rope-like tissue that connect bones to other bones, and hold them in place, providing stability to the joints. The Plantar fascia is the largest ligament in the foot, originating from the heel bone to the forefoot. It extends along the bottom surface of the foot and is involved in maintaining the arch of the foot. The plantar fascia ligament stretches and contracts to provide balance and strength to the foot. Lateral ligaments on the outside of the foot and medial ligaments on the inside of the foot provide stability and allow up and down movement of the foot. Muscles in the Foot and Ankle The foot is made up of 20 muscles, which help in movement. The main muscles include: Anterior tibial muscle: allows up and down movement of the foot Posterior tibial muscle: supports the arch Peroneal tibial muscle: controls movement on the outside of the ankle Extensors: enable the ankle to raise the toes just before stepping forward Flexors: stabilize the toes against the floor Smaller muscles are also present to help the toes lift and curl. Tendons in the Foot and Ankle Tendons are sof t tissues that connect muscles to bones. The largest and strongest tendon in the foot is the Achilles tendon, present at the back of the lower leg around the heel bone. Other tendons include peroneals and anterior and posterior tibialis. Bursae in the Foot and Ankle Bursae are small fluid filled sacs that decrease friction between tendons and bone or skin. Bursae contain special cells called synovial cells that secrete a lubricating fluid.

  Link: Foot & Ankle

• Hand

  CARPAL TUNNEL RELEASE What is Carpal Tunnel Syndrome? Carpal Tunnel Syndrome is a common, painful, progressive condition that is caused by compression of the median nerve at the wrist area. Common symptoms of carpal tunnel syndrome include numbness and tingling sensation in all the fingers except the little finger; pain and burning sensation in hand and wrist that may radiate up the arm and elbow; and weakness in hand with diminished grip strength. Carpal tunnel syndrome may be treated using conservative approaches or surgery. If conservative treatment options fail to resolve the condition your surgeon may recommend surgery. Carpal Tunnel Release Surgery Carpal tunnel syndrome can be treated with carpal tunnel release surgery. Traditional surgery involves up to a 2- inch incision in the palm and wrist area, whereas endoscopic surgery involves one or two half-an-inch incisions and the use of an endoscope. During the surgery, the transverse carpal ligament will be dissected to release the pressure on the median nerve and enlarge the carpal tunnel. Your surgeon will decide which options are best for you based on your general and medical conditions. Postoperative Care for Carpal Tunnel Release Your surgeon may suggest you practice certain Postoperative procedures for better recovery and to avoid further complications. Elevate the hand above heart level to reduce swelling. A splint may be worn Ice packs to the surgical area to reduce swelling. Keep the surgical incision clean and dry. Cover the area with plastic wrap when bathing or showering. Physical therapy may be ordered to restore wrist strength. Eating a healthy diet and not smoking will promote healing Risks and Complications Associated with Carpal Tunnel Release Most patients suffer no complications following carpal tunnel release surgery. However, some patients may suffer from pain, infections, scarring, and nerve damage causing weakness, paralysis, or loss of sensation and stiffness in the hand and wrist area. TRIGGER FINGER RELEASE What is a Trigger Finger? The ability to bend the fingers is governed by supportive tendons that connect muscles to the bones of the fingers. When the fingers bend, or are straightened, a slippery coating called tenosynovium helps the tendons smoothly glide through the ligaments with reduced friction. Inflammation in the tenosynovium leads to a condition called trigger finger, also known as stenosing tenosynovitis or flexor tendonitis, where one of the fingers or thumb of the hand is caught in a bent position. If conservative treatment options fail to resolve the condition and symptoms persist for 6 months or more and your quality of life is adversely affected, your surgeon may recommend you undergo a surgical procedure to release the tendon. Trigger Finger Release Surgery Percutaneous trigger finger release surgery is a minimally invasive procedure performed under local anesthesia. Your surgeon makes one small incision to the affected finger area, about inch long, and releases the tight portion of the flexor tendon sheath.

  Link: Hand