Trigger Finger
What is trigger finger?
As the name suggests, trigger finger is a condition wherein your finger gets bent or straightened like a trigger being pulled and released. The condition is accompanied with the finger getting stuck in a bent position. It also goes by the name of Digital tenovaginosis or stenosing tenosynovitis. It primarily occurs when due to inflammation, the space within the sheath that surrounds the tendon gets narrowed. The underlying cause is unknown but the condition is certainly more common in patients with diabetes. People with rheumatoid disease may develop synovial thickening or intratendinous nodule which can also Cause triggering. Occupational factors, though sometimes blamed, are unlikely to be causative.
Symptoms
The various symptoms of trigger finger include-
- A clicking sensation on the movement of finger
- Stiffness in your finger.
- Soreness or bump at the base of the affected finger or thumb.
- Your finger might get locked and doesn’t move.
Clinical Feature
Any digital may be affected, but the thumb, ring and middle fingers are the most common areas; sometimes several fingers are flexed. When the hand is unclenched, the affected finger initially remains bent at the PIP joint but with further effort it suddenly straightens with a snap. A tender nodule can be felt in front of the MCP joint and the click may be reproduced at this site by alternately flexing and extending the finger.
Infantile trigger thumb
Parents sometimes notice that their infant cannot extend the thumb tip. The diagnosis is often missed, or the condition is wrongly taken for a ‘dislocation’. Very occasionally the child grows up with the thumb permanently bent. This condition must be distinguished from the rare congenitally clasped thumb in which both the IP joint and the MCP joint are flexed.
Treatment
- In adults, early cases may be cured by an injection of corticosteroid carefully placed at the mouth of the tendon sheath. Recurrent triggering up to 6 months later occurs in over 30% of patients and those with diabetes, who may then need a second injection.
- Refractory cases need operation, through an incision over the distal palmar crease, or in the MCP crease of the thumb-the A1 section of the fibrous sheath is incised until the tendon moves freely.
In babies it is worth waiting until the child is about 3 years old, as spontaneous recovery often occurs. If not, then the pulley is released.