trigger finger

Question 1

what is trigger finger?

Answer 1

Trigger finger (stenosing flexor tenosynovitis) is a condition in which the finger or thumb click or lock when in flexion, preventing a return to extension.

Question 2

what is the pathophysiology of trigger finger?

Answer 2

usually proceeded by flexor tendosynovitis, often from repetitive movements, leading to inflammation of tendon and sheath

Question 3

what is tendosynovitis?

Answer 3

Tenosynovitis is the inflammation of the fluid-filled sheath (called the synovium) that surrounds a tendon, typically leading to joint pain, swelling, and stiffness.

Tenosynovitis can be either infectious or noninfectious.

Question 4

what are the risk factors for trigger finger?

Answer 4

• prolonged gripping and use of hand in a occupation or hobby
• RA
• DM
• female
• increasing age

Question 5

what are the clinical features?

Answer 5

• painless clicking/snapping/catching when trying to extend their finger
• may become painfull over time

Question 6

what are your differentials?

Answer 6

• dupuytrens contracture
• infection within tendon sheath
• ganglion
• acromegaly

Question 7

how is trigger finger managed conservatively?

Answer 7

generally this is the method of choice

• advice on activities that cause pain
• splint to keep finger in extension at night
• steroid injections can be trialled

Question 8

how is trigger finger managed surgically?

Answer 8

percutaneous trigger finger release via needle can be attempted in most cases

can also do surgical decompression of tendon tunnel

Question 9

what are the complications of surgery?

Answer 9

Recurrence of triggering following surgery is uncommon, however adhesions can form if the patient does not begin immediate motion following surgery.