Trigger Finger

Introduction

Trigger finger (also called stenosing flexor tenosynovitis) is a condition that causes pain, stiffness and a sensation of locking or catching when the digit is flexed and extended.

  • The patient may present with a digit locked in a particular position, most often flexion (bent position), which may require gentle, passive manipulation into full extension.
  • It can occur in one or more fingers in each hand and can be bilateral.

Trigger Finger



Risk Factors

The cause of trigger finger is most frequently unclear, although patients often attribute it to overuse or repetitive movements.

Trigger finger is most common among women in the fifth or sixth decade of life.

The prevalence of trigger finger is also higher among patients with diabetes mellitus, rheumatoid arthritis, or conditions that cause systemic deposition of protein such as amyloidosis.



Treatment

The goals of treatment of trigger finger are to alleviate pain and to allow smoother movement of the finger with flexion and extension.

Conservative interventions which include activity modification, splinting and/or short-term NSAIDs

  • Patients should be advised against heavy lifting, manual work, gardening or other symptom-triggering activities.
  • The splint can be worn based on trigger pattern and patient preferences (e.g. daytime use, nighttime use, or use with activity). The suggested duration of splinting is generally 3-6 weeks.
  • A concurrent trial of NSAIDs for a maximum duration of 2-4 weeks for pain relief, unless contraindicated by gastrointestinal, renal or heart disease.

Local glucocorticoid injection

  • Suggested for patients whose symptoms have not resolved after 4-6 weeks of conservative therapy.

Surgical release

  • Generally reserved for patients who have failed conservative therapy and have not improved with one or two glucocorticoid injections.



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