Trigger Finger

This is a common condition associated with inflammation of the tendon lining. Patients with this problem presents with pain and catching of the affected finger.. Bending or straightening of the finger commonly associates with a ‘clicking’ sound. Tendons that help bend the fingers and thumb slide through a snug tunnel.

Repetitive movement of the flexor tendon slipping into and out the tunnel can cause the opening of the tunnel to become thicker and smaller and or the tendon lining thicken so that it cannot easily pass through the tunnel. As you try to straighten the finger, the tendon becomes momentarily stuck at the mouth of the tunnel then pops as the tendon slips past the tight area. This can cause pain and catching as you try to move the finger.

Figure A: Finger in a straight position

Figure B: When the finger is flexed, the tendon lining swells up and causes the finger to lock.

Figure C shows a steroid injection into the tendon sheath.

If non-surgical forms of treatment do not relieve the symptoms, surgery may be recommended.

The goal of treatment in trigger finger/thumb is to eliminate the catching or locking and allow full movement of the finger or thumb without discomfort. Swelling around the flexor tendon and tendon sheath must be reduced to allow smooth gliding of the tendon. Stretching of the fingers and taking an oral anti-inflammatory medication may sometimes help. An injection of steroid into the area around the tendon and pulley is often effective in relieving the trigger finger/thumb.

Figure D: Surgical incision	Figure E: Wound following closure

Uncommon complications like tendon lacerations, injury to the digital nerves and wound infection are possible. In severe cases, contractures of the fingers can occur but these can be addressed with therapy.