{"id":423783,"date":"2026-08-23T00:07:02","date_gmt":"2026-08-23T04:07:02","guid":{"rendered":"https:\/\/www.eldiario.net\/portal\/?p=423783"},"modified":"2026-08-22T08:08:09","modified_gmt":"2026-08-22T12:08:09","slug":"dedo-en-gatillo-tenosinovitis-estenosante","status":"publish","type":"post","link":"https:\/\/www.eldiario.net\/portal\/2026\/08\/23\/dedo-en-gatillo-tenosinovitis-estenosante\/","title":{"rendered":"DEDO EN GATILLO (Tenosinovitis Estenosante)"},"content":{"rendered":"<p><strong>Lic. Jaime J. Ticona Pardo, Fisioterapeuta Kinesi\u00f3logo<\/strong> &#8211;\u00a0 <strong><em>72556224<\/em><\/strong><\/p>\n<p><strong>Diagn\u00f3stico y Manejo Fisioterap\u00e9utico<\/strong><\/p>\n<p>El dedo en gatillo, o tenosinovitis estenosante, ocurre por un atrapamiento mec\u00e1nico de los tendones flexores (superficial y profundo) al deslizarse a trav\u00e9s del sistema de poleas digitales, espec\u00edficamente en la <strong>polea A1<\/strong> a nivel de la cabeza del metacarpiano. Un microtraumatismo repetitivo o fuerzas de cizallamiento generan inflamaci\u00f3n, engrosamiento y, eventualmente, la formaci\u00f3n de un n\u00f3dulo tendinoso que dificulta la extensi\u00f3n fluida del dedo.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Mecanismo Biomec\u00e1nico y Etiolog\u00eda<\/strong><\/p>\n<p>El conflicto de espacio altera la relaci\u00f3n contenido-continente. Al flexionar el dedo, el n\u00f3dulo tendinoso atraviesa la polea <strong>A1<\/strong> estenosada; al intentar extenderlo, el n\u00f3dulo queda atrapado distal a la polea, produciendo el cl\u00e1sico bloqueo o salto brusco.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Factores de riesgo:<\/strong> Movimientos repetitivos de prensi\u00f3n manual, uso prolongado de herramientas y enfermedades sist\u00e9micas concomitantes como diabetes mellitus o artritis reumatoide.<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>Dedos m\u00e1s afectados:<\/strong> Dedo anular, pulgar y medio.<\/p>\n<p><strong>Clasificaci\u00f3n Cl\u00ednica (Escala de Green)<\/strong><\/p>\n<ul>\n<li><strong>Grado I (Pre-gatillo):<\/strong> Dolor localizado en la polea A1 y sensibilidad a la palpaci\u00f3n; sin bloqueo evidente.<\/li>\n<li><strong>Grado II (Activo):<\/strong> Atrapamiento o salto demostrable, pero el paciente logra la extensi\u00f3n de forma activa.<\/li>\n<li><strong>Grado III (Pasivo):<\/strong> Bloqueo severo que requiere asistencia de la mano contralateral para lograr la extensi\u00f3n (Grado III-A) o incapacidad de flexionar por completo (Grado III-B).<\/li>\n<li><strong>Grado IV (Fijo):<\/strong> Deformidad fija en flexi\u00f3n por contractura articular secundaria.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>Tratamiento Fisioterap\u00e9utico Basado en la Evidencia<\/strong><\/p>\n<p>En estadios I a III-A, el tratamiento conservador muestra tasas de \u00e9xito elevadas sin necesidad de infiltraci\u00f3n o liberaci\u00f3n quir\u00fargica.<\/p>\n<p>&nbsp;<\/p>\n<ol>\n<li><strong> Inmovilizaci\u00f3n Funcional (Ortesis)<\/strong><\/li>\n<\/ol>\n<ul>\n<li>Uso de ortesis a medida en extensi\u00f3n de la articulaci\u00f3n metacarpofal\u00e1ngica (MCF). durante 4 a 6 semanas, dejando libres las interfal\u00e1ngicas. Esto reduce la fricci\u00f3n en la polea A1 y favorece el remodelado tisular.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ol start=\"2\">\n<li><strong> Terapia Manual y Modulaci\u00f3n del Dolor<\/strong><\/li>\n<\/ol>\n<ul>\n<li><strong>Masaje de fricci\u00f3n transversal profundo (Cyriax):<\/strong> Sobre la polea A1 para flexibilizar la fibrosis tisular.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li><strong>Terapia de ondas de choque extracorp\u00f3reas (ESWT):<\/strong> Aplicaci\u00f3n de baja a media energ\u00eda para estimular la angiog\u00e9nesis y desinflamar la vaina tendinosa.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ol start=\"3\">\n<li><strong> Ejercicio Terap\u00e9utico y Deslizamiento Neural\/Tendinoso<\/strong><\/li>\n<\/ol>\n<ul>\n<li><strong>Deslizamiento tendinoso:<\/strong> Secuencia de posiciones (mano abierta, garra, pu\u00f1o plano y pu\u00f1o completo) para maximizar la excursi\u00f3n del tend\u00f3n flexor sin carga excesiva.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li><strong>Movilizaci\u00f3n activa dosificada:<\/strong> Ejercicios de extensi\u00f3n isom\u00e9trica y estiramiento pasivo controlado de la cadena flexora.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>En casos donde persiste la contractura fija (Grado IV) o fracasa el abordaje conservador tras 8-12 semanas, la liberaci\u00f3n percut\u00e1nea o quir\u00fargica de la polea A1 es la indicaci\u00f3n principal, seguida de rehabilitaci\u00f3n postquir\u00fargica inmediata para evitar adherencias.<\/p>\n<h3><strong><em>\u201cEL MOVIMIENTO ES TU PROPIA MEDICINA, SOLO HAY QUE AJUSTAR LA DOSIS\u201d.<\/em><\/strong><\/h3>\n\r\n                <style type=\"text\/css\">\r\n                    \r\n                    #tdi_1  .td-doubleSlider-2 .td-item1 {\r\n                        background: url(https:\/\/www.eldiario.net\/portal\/wp-content\/uploads\/2026\/08\/DEDO-EN-GATILLO-Tenosinovitis-Estenosante-2-copia-80x60.webp) 0 0 no-repeat;\r\n                  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Jaime J. Ticona Pardo, Fisioterapeuta Kinesi\u00f3logo &#8211;\u00a0 72556224 Diagn\u00f3stico y Manejo Fisioterap\u00e9utico El dedo en gatillo, o tenosinovitis estenosante, ocurre por un atrapamiento mec\u00e1nico de los tendones flexores (superficial y profundo) al deslizarse a trav\u00e9s del sistema de poleas digitales, espec\u00edficamente en la polea A1 a nivel de la cabeza del metacarpiano. Un microtraumatismo [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":423784,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[52],"tags":[],"class_list":["post-423783","post","type-post","status-publish","format-standard","has-post-thumbnail","category-de-salud-mas-vida"],"acf":{"antetitulo":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>DEDO EN GATILLO (Tenosinovitis Estenosante) - El Diario - Bolivia<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.eldiario.net\/portal\/2026\/08\/23\/dedo-en-gatillo-tenosinovitis-estenosante\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"DEDO EN GATILLO (Tenosinovitis Estenosante) - El Diario - Bolivia\" \/>\n<meta property=\"og:description\" content=\"Lic. Jaime J. Ticona Pardo, Fisioterapeuta Kinesi\u00f3logo &#8211;\u00a0 72556224 Diagn\u00f3stico y Manejo Fisioterap\u00e9utico El dedo en gatillo, o tenosinovitis estenosante, ocurre por un atrapamiento mec\u00e1nico de los tendones flexores (superficial y profundo) al deslizarse a trav\u00e9s del sistema de poleas digitales, espec\u00edficamente en la polea A1 a nivel de la cabeza del metacarpiano. Un microtraumatismo [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.eldiario.net\/portal\/2026\/08\/23\/dedo-en-gatillo-tenosinovitis-estenosante\/\" \/>\n<meta property=\"og:site_name\" content=\"El Diario - Bolivia\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/eldiario.bolivia\/\" \/>\n<meta property=\"article:published_time\" content=\"2026-08-23T04:07:02+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.eldiario.net\/portal\/wp-content\/uploads\/2026\/08\/DEDO-EN-GATILLO-Tenosinovitis-Estenosante-2-copia.webp\" \/>\n\t<meta property=\"og:image:width\" content=\"800\" \/>\n\t<meta property=\"og:image:height\" content=\"600\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/webp\" \/>\n<meta name=\"author\" content=\"Jeanette\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@eldiario_net\" \/>\n<meta name=\"twitter:site\" content=\"@eldiario_net\" \/>\n<meta name=\"twitter:label1\" content=\"Escrito por\" \/>\n\t<meta name=\"twitter:data1\" content=\"Jeanette\" \/>\n\t<meta name=\"twitter:label2\" content=\"Tiempo de lectura\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/www.eldiario.net\\\/portal\\\/2026\\\/08\\\/23\\\/dedo-en-gatillo-tenosinovitis-estenosante\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.eldiario.net\\\/portal\\\/2026\\\/08\\\/23\\\/dedo-en-gatillo-tenosinovitis-estenosante\\\/\"},\"author\":{\"name\":\"Jeanette\",\"@id\":\"https:\\\/\\\/www.eldiario.net\\\/portal\\\/#\\\/schema\\\/person\\\/7f32545115b096f29aabdeed99c3e706\"},\"headline\":\"DEDO EN GATILLO (Tenosinovitis Estenosante)\",\"datePublished\":\"2026-08-23T04:07:02+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/www.eldiario.net\\\/portal\\\/2026\\\/08\\\/23\\\/dedo-en-gatillo-tenosinovitis-estenosante\\\/\"},\"wordCount\":500,\"publisher\":{\"@id\":\"https:\\\/\\\/www.eldiario.net\\\/portal\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/www.eldiario.net\\\/portal\\\/2026\\\/08\\\/23\\\/dedo-en-gatillo-tenosinovitis-estenosante\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/www.eldiario.net\\\/portal\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/DEDO-EN-GATILLO-Tenosinovitis-Estenosante-2-copia.webp\",\"articleSection\":[\"De Salud + vida\"],\"inLanguage\":\"es\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.eldiario.net\\\/portal\\\/2026\\\/08\\\/23\\\/dedo-en-gatillo-tenosinovitis-estenosante\\\/\",\"url\":\"https:\\\/\\\/www.eldiario.net\\\/portal\\\/2026\\\/08\\\/23\\\/dedo-en-gatillo-tenosinovitis-estenosante\\\/\",\"name\":\"DEDO EN GATILLO (Tenosinovitis Estenosante) - 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