Trigger finger

Question 1

What is trigger finger?

Answer 1

This is swelling of the flexor tendon sheath, through which tendons to the fingers run, causing catching of tendon nodules on the edge of the A1 pulley, leading to locked finger contraction

Question 2

Who is most at risk of trigger finger?

Answer 2

Females
>50 years old
Diabetics

Question 3

Describe the pathophysiology of trigger finger

Answer 3

Stenosing tenosynovitis =>
Irritation =>
Fibrocartilaginous metaplasia (Further swelling) =>
Nodule formation on flexor digitorum superficialis tendon =>
loss of smooth muscle gliding of the finger tendons under the annular A1 pulley

Question 4

How can trigger finger present?

Answer 4

Pain over metacarpal head
Locked, flexed finger

Question 5

What are the 3 forms of management for trigger finger?

Answer 5

Conservative
Tendon sheath injection
Surgery

Question 6

What are some conservative managements used in trigger finger?

Answer 6

Splinting to prevent flexion (Will often resolve spontaneously)

Question 7

What is involved in tendon sheath injections?

Answer 7

Steroid and local anaesthetic injections into the flexor tendon sheath
This is often curative and may be repeated up to 2 times

Question 8

Describe the surgical option in trigger finger management

Answer 8

Surgery can be performed under local or general anaesthetic and involved division of the A1 pulley