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Evaluation and Diagnosis of Trigger Finger with Current Management Strategies

The pathological process required to create trigger finger involves thickening of the first digital, annular (A1) retinaculum that serves as a pulley sheath along the metacarpophalangeal (MCP) joint. With annular narrowing, the digital flexor tendon loses the ability to relax following flexion, resulting in a “triggered finger.” Possible etiologies responsible for fibrosis of the the A1 retinaculum include diabetes mellitus (DM), amyloidosis, repetitive hand motions, and carpal tunnel release (CTR); however, in most patients the cause is often idiopathic. A recent review has postulated that viewing CTR as a cause of trigger finger may actually be the result of a publication bias. It is also…

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Articles of Interest

Do You Have Trigger Finger?

Depending on the severity, trigger finger can range from a minor nuisance to extreme pain that interferes with daily activities. Fortunately, trigger finger is easily treated and—in many cases—cured.

StatPearls

Trigger finger, or stenosing tenosynovitis, is tenosynovitis of the flexor sheaths that typically occurs in the 4th finger and thumb as a result of repetitive use. It is a common condition that can cause significant functional impairment.

Trigger finger in adults

The lifetime risk is about 2% to 3%, with women affected more frequently than men. The risk is as high as 10% among people with diabetes mellitus. The ring finger and thumb are most frequently affected.

Trigger finger treatment without surgery

A temporary sticking or popping in any finger or thumb when you bend the finger — trigger finger — can be treated without surgery, but in some cases an outpatient procedure may be needed to free the inflamed tendon causing the condition.

Resources

Handcare

Trigger fingers are more common with certain medical conditions. Rheumatoid arthritis, gout and diabetes are risk factors for this condition. Repeated and strong gripping may lead to the condition. In most cases, the cause of the trigger finger is not known.

OrthoInfo

The vast majority of patients who have surgery experience significant improvement in function as well as relief from the pain of a trigger finger. Still, if a contracture (abnormal shortening or tightening of tissues) or loss of motion was present before surgery, complete range of motion may not be fully restored.

Physiopaedia

Trigger finger is thought to be caused by inflammation and subsequent narrowing of the A1 pulley of the affected digit, typically the third or fourth. The A1 pulley is most often affected, but there are some reported cases where the A2 and A3 pulleys were involved.