Trigger Finger or Thumb is when the digit suddenly catches, called triggering – it can get stuck or locked into a bent position, sometimes returning with a painful snap.
In more severe cases, the finger or thumb requires manual straightening using the other hand, to return it to position.
Due to the pain and hesitancy to bend the finger some people may lose flexion (bending) of the finger and the joint can start to become stiff (contracted).
While causes of Trigger Finger and Thumb are not fully understood, there are factors which increase the risk of it developing:
It is often difficult to pin point a cause of Trigger Finger or Thumb, but it can follow periods of extensive hand use, particularly pinching or grasping.
Symptoms include:
The flexor tendons make the fingers bend. These are cord-like structures that run from the forearm into the fingers. Each tendon travels in a tendon sheath (tunnel) in the finger to enable it to move smoothly, which is held to the finger bones. Certain areas of the tunnel are thickened with tissue known as ‘pulley’s’. At the base of each finger one of these is called the A1 pulley.
When the A1 pulley becomes thickened or inflamed, the tendon cannot move freely through the tendon sheath, causing the digit to stick in one place. Secondary inflammation can make this particularly painful.
The condition is also known as Stenosing Tenosynovitis and most commonly affects the ring finger and thumb. Over time it may cause the flexor tendon itself to become damaged or develop a small nodule, restricting movement further.
Early treatment will include a non-surgical approach and may include:
If nonoperative treatment does not provide adequate relief, surgery can be considered:
Percutaneous Release
A minimally invasive and successful procedure where a needle is inserted to break up the tightened tissue around the tendon sheath.
Open surgery
A small incision in the palm to access the tendon sheath and A1 pulley which is cut open to allow more space for the tendon to move. This is a day procedure usually under local anaesthetic +/- sedation and is a highly successful procedure for recovering mobility. This is my preferred surgical option.
These notes have been prepared by orthopaedic surgeons at OrthoSport Victoria. They are a general overview and reflect their views, opinions and recommendations. The contents are provided for information and education purposes only and not for the purpose of rendering medical advice. Please seek the advice of your surgeon or other health care provider with any questions regarding medical conditions and treatment.
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