Trigger Finger

Common Upper Limb & Hand Conditions Trigger Finger

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What is a trigger finger?

Adult trigger finger is a common condition that presents with catching or locking of a finger with or without associated pain. In advanced cases, fingers can bend but get “locked” and cannot straighten unless helped by the other hand. It is commonly associated with diabetes, rheumatoid arthritis or gout and even Dupuytren's contracture.

The tendons that bend the fingers are kept close to the surface of the bone by pulleys that ensure full bending of the fingers. In an adult trigger finger, the A1 pulley inner surface becomes thickened by a process called fibrocartilaginous metaplasia. The tendons at this level are lined with a membrane called the synovial sheath. When the space in the tunnel becomes smaller, the synovial lining starts to swell, and it gets even more difficult to straighten the finger. The combination of mechanical obstruction and swelling can create damage to the underlying tendon and worsen the problem.

What are the symptoms of a trigger finger?

Signs and symptoms of trigger finger range from mild to severe and may include finger stiffness, especially in the morning, a clicking or popping sensation when you move your finger, or tenderness or a hand bump at the base of the affected finger. Other symptoms may include finger catching or locking in a bent position, which may or may not pop up.

Trigger finger may affect any finger, including your thumb, and more than one finger on both hands may be affected at the same time.

How is a trigger finger treated?

Steroid injections are tried initially, and although it does not reverse the original problem, it is believed to reduce the reactive and swollen synovial sheath and are effective. Depending on your condition, Dr van der Spuy may recommend surgery to divide and release the A1 pulley to create more space for the tendon to glide smoothly. It generally has an excellent and predictable outcome.

Rehabilitation post Trigger finger release.

The dressing must be kept on and remain dry for two weeks post-surgery. It is imperative that the finger starts moving immediately after the finger surgery to keep the tendons gliding and prevent scar adhesions. The finger will stop locking or catching immediately after the procedure.

The sutures are removed at 14 days post-surgery. Hand therapy may be necessary for swelling and scar management, as well as regaining full straightening of the operated finger, as it has a tendency to bend at the middle joint. Any tenderness should resolve around 6-12 weeks post-surgery.

FAQ

1Can trigger finger heal independently?
Trigger finger may dissipate over time, depending on the severity of the condition. Rest, anti-inflammatories and splinting are conservative treatment measures for trigger fingers.
2What causes a trigger finger?
A trigger finger develops when the tendon that flexes the finger is unable to move smoothly within the tendon sheath due to a mechanical restriction caused by the pulley.
3How long does a trigger finger take to disappear?
Trigger fingers can take weeks or months to dissipate, depending on a variety of factors.

Please read the above text for more in-depth information to help answer these questions. It's important to consult with our qualified healthcare professionals to ensure the appropriate diagnosis and treatment plan for your specific situation.