A Man With Shrinking Fingers

Chris D. Tzarnas, MD; Carl H. Manstein, MD, MBA


October 01, 2015

Clinical Presentation: Contracture of the Thumb

A 66-year-old man of Eastern European ancestry presents with Fitzpatrick skin type II. He is of excellent health, does not smoke or drink, and eats a vegetarian diet. He is an avid runner, and recently had a colonoscopy that was negative. Relevant medical history includes:

  • 2006: Surgical removal of nasal polyps

  • 2008: Orthopedic procedure for stress fracture of right foot

  • 2010: Excision of squamous cell carcinoma in situ of right lower lip

  • 2012: Release of trigger of right thumb

  • 2014: Release of trigger of left thumb

In 2009 he underwent an operation on the palmar surface of his left hand at the level of the metacarpophalangeal joint of the small finger. The operation was performed because of a "thickening" and nodular formation of the skin on the palm, making it difficult for him to extend his left small finger. This was very annoying to him because he has been studying classical piano for many years as an adult.

Figures 1-3. Patient's left hand at most recent examination.

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