Trigger finger: Difference between revisions
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{{Infobox medical condition | |||
| name = Trigger finger | |||
| image = [[File:TriggerFinger.webm]] | |||
| caption = Video of a person with trigger finger | |||
| field = [[Orthopedics]] | |||
| synonyms = Stenosing tenosynovitis | |||
| symptoms = [[Pain]], [[stiffness]], and a sensation of locking or catching when bending and straightening the finger | |||
| complications = [[Permanent contracture]] | |||
| onset = Most common in people aged 40 to 60 | |||
| duration = Can be chronic if untreated | |||
| causes = [[Repetitive strain]], [[rheumatoid arthritis]], [[diabetes mellitus]] | |||
| risks = [[Occupation]]s involving repetitive gripping actions | |||
| diagnosis = Based on [[physical examination]] | |||
| differential = [[Dupuytren's contracture]], [[osteoarthritis]], [[carpal tunnel syndrome]] | |||
| prevention = Avoiding repetitive hand movements | |||
| treatment = [[Splinting]], [[nonsteroidal anti-inflammatory drug|NSAIDs]], [[steroid injection]]s, [[surgery]] | |||
| medication = NSAIDs, [[corticosteroid]]s | |||
| prognosis = Good with treatment | |||
| frequency = Affects 2-3% of the general population | |||
}} | |||
==What is trigger finger?== | ==What is trigger finger?== | ||
Trigger finger is a disorder where a finger or thumb gets stuck in a bent position, as if you were squeezing a trigger. Also, once it gets unstuck, the finger pops straight out, like a trigger being released. | Trigger finger is a disorder where a finger or thumb gets stuck in a bent position, as if you were squeezing a trigger. Also, once it gets unstuck, the finger pops straight out, like a trigger being released. | ||
[[File:Post-operative photo of trigger finger release surgery.jpg|thumb|Post operative photo of trigger finger release surgery in a diabetic patient]] | [[File:Post-operative photo of trigger finger release surgery.jpg|left|thumb|Post operative photo of trigger finger release surgery in a diabetic patient]] | ||
==What causes trigger finger?== | ==What causes trigger finger?== | ||
* The tendons that move the finger slide through a tendon sheath and if the tunnel swells and becomes smaller, or the tendon has a bump on it, the tendon cannot slide smoothly through the tunnel. | * The tendons that move the finger slide through a tendon sheath and if the tunnel swells and becomes smaller, or the tendon has a bump on it, the tendon cannot slide smoothly through the tunnel. | ||
* When it cannot slide smoothly, the tendon may become stuck when you try to straighten your finger. | * When it cannot slide smoothly, the tendon may become stuck when you try to straighten your finger. | ||
==Signs and symptoms== | ==Signs and symptoms== | ||
* Symptoms include catching or locking of the involved finger. | * Symptoms include catching or locking of the involved finger. | ||
* In the ring and middle fingers, often a nodule can be felt at the area of the hand where the palm meets the finger. | * In the ring and middle fingers, often a nodule can be felt at the area of the hand where the palm meets the finger. | ||
==Diagnosis== | ==Diagnosis== | ||
* Diagnosis is made almost exclusively by history and physical examination alone. | * Diagnosis is made almost exclusively by history and physical examination alone. | ||
* More than one finger may be affected at a time, though it usually affects the index, thumb, middle, or ring finger. | * More than one finger may be affected at a time, though it usually affects the index, thumb, middle, or ring finger. | ||
* The triggering is usually more pronounced late at night and into the morning, or while gripping an object firmly. | * The triggering is usually more pronounced late at night and into the morning, or while gripping an object firmly. | ||
==Treatment== | ==Treatment== | ||
* Treatment consists of injection of a corticosteroid such as [[methylprednisolone]] often combined with a local anesthetic ([[lidocaine]]) at the site of maximal inflammation or tenderness around the A1 pulley of the finger in the palm. | * Treatment consists of injection of a corticosteroid such as [[methylprednisolone]] often combined with a local anesthetic ([[lidocaine]]) at the site of maximal inflammation or tenderness around the A1 pulley of the finger in the palm. | ||
* The infiltration of the affected site can be performed using standard anatomic landmarks or sonographically guided, and often needs to be repeated 2 or three times to achieve remission. | * The infiltration of the affected site can be performed using standard anatomic landmarks or sonographically guided, and often needs to be repeated 2 or three times to achieve remission. | ||
* An irreducibly locked trigger, often associated with a flexion contracture of the PIP joint, should not be treated by injections. | * An irreducibly locked trigger, often associated with a flexion contracture of the PIP joint, should not be treated by injections. | ||
===Surgery=== | ===Surgery=== | ||
For symptoms that have persisted or recurred for more than 6 months and/or have been unresponsive to conservative treatment, surgical release of the pulley may be indicated. | For symptoms that have persisted or recurred for more than 6 months and/or have been unresponsive to conservative treatment, surgical release of the pulley may be indicated. | ||
==Prognosis== | ==Prognosis== | ||
* The [[natural history of disease]] for trigger finger remains uncertain. | * The [[natural history of disease]] for trigger finger remains uncertain. | ||
Latest revision as of 19:08, 8 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC
| Trigger finger | |
|---|---|
| File:TriggerFinger.webm | |
| Synonyms | Stenosing tenosynovitis |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Pain, stiffness, and a sensation of locking or catching when bending and straightening the finger |
| Complications | Permanent contracture |
| Onset | Most common in people aged 40 to 60 |
| Duration | Can be chronic if untreated |
| Types | N/A |
| Causes | Repetitive strain, rheumatoid arthritis, diabetes mellitus |
| Risks | Occupations involving repetitive gripping actions |
| Diagnosis | Based on physical examination |
| Differential diagnosis | Dupuytren's contracture, osteoarthritis, carpal tunnel syndrome |
| Prevention | Avoiding repetitive hand movements |
| Treatment | Splinting, NSAIDs, steroid injections, surgery |
| Medication | NSAIDs, corticosteroids |
| Prognosis | Good with treatment |
| Frequency | Affects 2-3% of the general population |
| Deaths | N/A |
What is trigger finger?[edit]
Trigger finger is a disorder where a finger or thumb gets stuck in a bent position, as if you were squeezing a trigger. Also, once it gets unstuck, the finger pops straight out, like a trigger being released.
What causes trigger finger?[edit]
- The tendons that move the finger slide through a tendon sheath and if the tunnel swells and becomes smaller, or the tendon has a bump on it, the tendon cannot slide smoothly through the tunnel.
- When it cannot slide smoothly, the tendon may become stuck when you try to straighten your finger.
Signs and symptoms[edit]
- Symptoms include catching or locking of the involved finger.
- In the ring and middle fingers, often a nodule can be felt at the area of the hand where the palm meets the finger.
Diagnosis[edit]
- Diagnosis is made almost exclusively by history and physical examination alone.
- More than one finger may be affected at a time, though it usually affects the index, thumb, middle, or ring finger.
- The triggering is usually more pronounced late at night and into the morning, or while gripping an object firmly.
Treatment[edit]
- Treatment consists of injection of a corticosteroid such as methylprednisolone often combined with a local anesthetic (lidocaine) at the site of maximal inflammation or tenderness around the A1 pulley of the finger in the palm.
- The infiltration of the affected site can be performed using standard anatomic landmarks or sonographically guided, and often needs to be repeated 2 or three times to achieve remission.
- An irreducibly locked trigger, often associated with a flexion contracture of the PIP joint, should not be treated by injections.
Surgery[edit]
For symptoms that have persisted or recurred for more than 6 months and/or have been unresponsive to conservative treatment, surgical release of the pulley may be indicated.
Prognosis[edit]
- The natural history of disease for trigger finger remains uncertain.
- There is some evidence that idiopathic trigger finger behaves differently in people with diabetes.
- Recurrent triggering is unusual after successful injection and rare after successful surgery.
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