TRIGGER FINGER                                                   KANDIL NOTES

INTRODUCTION

  • Trigger finger is an inflammatory condition of the hand where one of the hand tendons gets “stuck” behind one of the pulleys that keep the tendon on track

  • It affects women six times more often than men

  • CAUSES

  • The exact pathophysiology is unknown

  • Contributing factors include genetic changes, workplace factors, and medical conditions such as diabetes and rheumatoid arthritis

  • SIGNS AND SYMPTOMS

  • Trigger finger is characterized by pain in the palm of the hand with bending as well as tendon getting stuck or locked when trying to straighten out the fingers

  • A tender nodule can be felt at the level of inflammation, the A1 pulley, in the palm of the hand

  • TREATMENT​​

  • Trigger finger oftentimes improves without surgery 

  • The first line of treatment involves a home exercise or supervised therapy program to decrease inflammation and pain

  • Bracing can be helpful by immobilizing the portion of the finger that is inflamed

  • Anti-inflammatories such as ibuprofen can be helpful in decreasing inflammation

  • Trigger finger steroid injections can help decrease inflammation and pain in the area of the inflamed pulley in the palm of the hand

  • Surgery is reserved for cases that don’t improve after a course of conservative management if symptoms are significantly affecting activities of daily living and quality of life. Surgery is composed of a small incision in the palm of the hand and release of the affected pulley. This is minimally invasive and is done under local anesthesia and mild sedation. Recurrence is rare after open release

        PREVENTION

  • For patients with diabetes or thyroid issues, managing their glucose or thyroid hormone levels is very important

Trigger finger capture 1.PNG