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Trigger finger information


Trigger finger
Other namesHistoricopous, trigger digit, trigger thumb,[1] stenosing tenosynovitis[1]
An example of trigger finger affecting the ring finger
SpecialtyHand surgery, orthopedic surgery, and plastic surgery
SymptomsCatching or locking of the involved finger, pain[2][3]
Usual onset50s to 60s years old[2]
Risk factorsGenerally idiopathic, meaning no known cause. Perhaps diabetes[3]
Diagnostic methodSymptoms and signs[2]
Differential diagnosisSagittal band rupture
TreatmentSteroid injections, surgery. The role of splint immobilization is uncertain[3]
FrequencyRelatively common[2]

Trigger finger, also known as stenosing tenosynovitis, is a disorder characterized by catching or locking of the involved finger in full or near full flexion, typically with force.[2] There may be tenderness in the palm of the hand near the last skin crease (distal palmar crease).[3] The name "trigger finger" may refer to the motion of "catching" like a trigger on a gun.[2] The ring finger and thumb are most commonly affected.[1]

The problem is generally idiopathic (no known cause). People with diabetes might be relatively prone to trigger finger.[3] The pathophysiology is enlargement of the flexor tendon and the A1 pulley of the tendon sheath.[3][2] While often referred to as a type of stenosing tenosynovitis (which implies inflammation) the pathology is mucoid degeneration.[3] Mucoid degeneration is when fibrous tissue such as tendon has less organized collagen, more abundant extra-cellular matrix, and changes in the cells (fibrocytes) to act and look more like cartilage cells (chondroid metaplasia). Diagnosis is typically based on symptoms and signs after excluding other possible causes.[2]

Trigger digits can resolve without treatment. Treatment options that are disease modifying include steroid injections and surgery.[3] Splinting immobilization of the finger may or may not be disease modifying.

  1. ^ a b c "Trigger Finger - Trigger Thumb". OrthoInfo - AAOS. March 2018. Retrieved 25 June 2018.
  2. ^ a b c d e f g h Makkouk AH, Oetgen ME, Swigart CR, Dodds SD (June 2008). "Trigger finger: etiology, evaluation, and treatment". Current Reviews in Musculoskeletal Medicine. 1 (2): 92–96. doi:10.1007/s12178-007-9012-1. PMC 2684207. PMID 19468879.
  3. ^ a b c d e f g h Hubbard MJ, Hildebrand BA, Battafarano MM, Battafarano DF (June 2018). "Common Soft Tissue Musculoskeletal Pain Disorders". Primary Care. 45 (2): 289–303. doi:10.1016/j.pop.2018.02.006. PMID 29759125. S2CID 46886582.

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