About Trigger Fingers
Trigger finger, technically known as stenosing tenosynovitis, is a very common condition that can affect any finger. Patients will typically come in complaining that their finger sticks in a flexed position, especially in the morning. While they can usually force the finger to straighten, occasionally they will need to use the other hand to straighten the finger. In severe cases, the finger can become “locked” in flexion or extension. Many patients will have a sore area in the palm where the finger meets the palm.
Cause and Anatomy of Trigger Fingers
While some patients have an injury to the hand that causes the onset of symptoms, in most patients, there is not a definable reason for the condition. Trigger finger is associated with conditions like diabetes and Dupuytren’s disease but is not caused by those conditions.
The tendons that flex the finger run through a tight tunnel that is made up of a system of pulleys. If the tendon gets inflamed, it can catch on the edge of the tunnel as it goes in and out. In turn, the pulley itself can become thickened.
Diagnosis of Trigger Fingers
This condition can usually be diagnosed by physical exam alone. X-rays and MRI are generally not necessary. Tenderness in the palm where the finger meets the hand is common. One can frequently feel a “knot” in the palm that moves with finger motion. In many cases the triggering is visible.
What Are My Options?
Options include anti-inflammatory medications, such as ibuprofen or Naprosyn. A steroid injection may be recommended to decrease the inflammation. One injection is enough to make the symptoms completely disappear for many patients. Some patients require a second injection to make the symptoms go away. There is a subset of patients that will not respond to injections.
In trigger finger surgery, the first pulley is released which allows the tendon to move back and forth without clicking or catching (marked in red below). Dividing that pulley does not change the range of motion or strength of the finger. There are several different incisions that can be used to perform the surgery. This is based on your surgeon’s preference and the digit being addressed. In most cases, after a few months, the scars are generally barely visible. While a period of soreness is to be expected after any surgery, the recovery is usually fast with minimal to no downtime, depending on your job or hobbies.