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Παρασκευή 10 Μαΐου 2013

PRP surprising benefit in trigger finger

trigger finger
Cell based treatments like PRP and Stem cells are so new that giving patients reasonable and measured expectations is essential as a professional. Not to mention there are variables that can make someone a less than ideal candidate that necessitate grading someone’s chance for success for a cell based treatment lower. With all that said, there are surprising responses in some people. And it’s nice to beat expectations. 
 
Trigger finger is a condition where the tendon in a finger that normally flexes the finger gets caught and “jammed up”. Since this condition is a tendinopathy, treatment with PRP is an interesting idea. Trigger finger is typically thought of as a mechanical problem where the tendon is restricted by a layer of tissue called the A1 Pulley which normally helps to keep the tendon in place as it contracts. But under ultrasound the tendon itself in trigger finger patients has mild irregularities consistent with chronic tendon changes. Interestingly you don’t find much information in regards to PRP treatment for trigger finger. But the idea for treatment makes sense, is low risk, and worth a shot.

2 patients come to mind who had really great and unexpected responses to PRP treatment of their triggers fingers. One is a horse trainer with hands that have been beat up over many years of hard work. The other a research scientist having difficulty with manual dexterity due to his trigger fingers. Both have tried steroid injections numerous times, originally helping temporarily, but eventually providing limited to no benefit. Neither wanted to go for surgery, both were willing to try a cell based treatment.

The scientist had 2 fingers treated twice 2 years ago with PRP. He hasn’t complained of pain since then. The horse trainer had 2 fingers treated 2 months ago. His pain is minimal now, and he’s using both hands fully again. Both these cases are surprising, since both had trigger finger symptoms significant enough to warrant surgery. Whether their great results are due to using a volume of fluid sufficient to help loosen the A1 pulley, or using PRP helped treat the chronic tendon irritation, the results speak for themselves. PRP is a low risk treatment that helps to treat an actual tendon problem rather than simply mask the pain. Why is this not the first line treatment for all tendon injuries?

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