“Trigger finger” sounds like an unusual name for a musculoskeletal condition. Contrary to popular belief, it has nothing to do with pulling a trigger. The involved finger catches or even locks in place completely. Therefore, this condition causes one or more fingers to be stuck in a flexed (bent) position. The patient often needs to use their opposite hand to extend (straighten) the finger that is stuck. As they do this, the finger typically snaps abruptly – like a trigger being pulled and released. This snapping sensation occurs because the synovial sheath around the flexor tendon is inflamed and swollen. This decreases the space within that synovial sheath that the tendon normally slides through. With less space, the tendon gets stuck as it tries to slide. The medical term for a narrowed space is “stenosis” or “stenosing”. And the medical term for an inflamed tendon sheath is “tenosynovitis”. Therefore, the official term for “trigger finger” is “stenosing tenosynovitis”. Often patients can palpate (feel) a hard nodule at the point where the finger triggers. This nodule is the very focal area of swollen tendon sheath.
Sometimes this condition can be relieved by conservative measures including anti-inflammatory medications, wearing a finger brace, or a corticosteroid injection directly into the nodule. The steroids help to decrease inflammation in the area. But when conservative measures fail, a surgical release can be done and is successful over 90% of the time. The surgery involves releasing (cutting) the enlarged nodule of the synovial sheath so that the tendon can again slide freely without getting stuck. This is typically performed by an Orthopedic surgeon who specializes in hand conditions.
If you are interested in this condition and other pathology of the hand and fingers such as jersey finger, skiers thumb, mallet finger, or gamekeeper thumb, then sign-up for a Skin, Bones, Hearts, & Private Parts CME conference today!
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