Trigger finger is a common cause of hand pain. It is caused by stenosis at the level of the first annular (A1) pulley, which interrupts the smooth gliding of the underlying flexor tendons at the level of the metacarpophalangeal joint. Patients present with locking of the finger in flexion and clicking or snapping. It is important that GPs have an understanding of this condition, in order to help their patients deal with its sequelae. In this article the pathophysiology, clinical assessment and management of patients with suspected trigger finger are discussed.
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References
1.
AndersonB.KayeS. (1991) Treatment of flexor tenosynovitis of the hand (‘trigger finger') with corticosteroids. A prospective study of the response to local injection. Archives of Internal Medicine151(1): 153–156, doi: 10.1001/archinte.1991.00400010155024.
2.
BainG. I.WallworkN. A.PercutaneousA. (1999) Pulley release: A clinical study. Journal of Hand Surgery4(1): 45–50, doi: 10.1142/S0218810499000113.
ColbournJ.HeathN.ManaryS.PacificoD. (2008) Effectiveness of splinting for the treatment of trigger finger. Journal of Hand Therapy21(4): 336–343, doi: 10.1197/j.jht.2008.05.001.
5.
GulerF.KoseO.ErcanE. C.TuranA.CanboraK. (2013) Open versus percutaneous release for the treatment of trigger thumb. Orthopedics36(10): 1290–1294, doi: 10.3928/01477447-20130920-22.
6.
KameyamaM.MeguroS.FunaeO.AtsumiY.IkegamiH. (2009) The presence of limited joint mobility is significantly associated with multiple digit involvement by stenosing flexor tenosynovitis in diabetics. Journal of Rheumatology36: 1686–1690, doi: 10.3899/jrheum.081024.
7.
KatzmanB. M.SteinbergD. R.BozentkaD. J.CainE.CaliqiuiriD. A.GellerJ. (1999) Utility of obtaining radiographs in patients with trigger finger. American Journal of Orthopaedics28: 703–705, Retrieved from www.mdedge.com/amjorthopedics.
8.
MakkoukA. H.OetgenM. E.SwigartC. R.DoddsS. D. (2008) Trigger finger: Etiology, evaluation, and treatment. Current Reviews of Musculoskeletal Medicine1: 92–96, doi: 10.1007/s12178-007-9012-1.
9.
McAuliffeJ. A. (2010) Tendon disorders of the hand and wrist. Journal of the American Society for Surgery of the Hand35(5): 846–853, doi: 10.1016/j.jhsa.2010.03.001.
Peters-VeluthamaningalC.van der WindtD. A.WintersJ. C.Meyboom-de JongB. (2009) Corticosteroid injection for trigger finger in adults. The Cochrane Database of Systematic Reviews. Art. no.: CD005617. doi: 10.1002/14651858.CD005617.pub2.
12.
Peters-VeluthamaningalC.WintersJ. C.GroenierK. H.JongB. M. (2008) Corticosteroid injections effective for trigger finger in adults in general practice: A double-blinded randomised placebo controlled trial. Annals of the Rheumatic Diseases67(9): 1262–1266, doi: 10.1136/ard.2007.073106.
RodgersJ. A.McCarthyJ. A.TiedemanJ. J. (1998) Functional distal interphalangeal joint splinting for trigger finger in laborers: A review and cadaver investigation. Orthopedics21(3): 305–309, doi: 10.3928/0147-7447-19980301-13.
15.
RozentalT. D.ZurakowskiD.BlazarP. E. (2008) Trigger finger: Prognostic indicators of recurrence following corticosteroid injection. Journal of Bone and Joint Surgery, American Volume90(8): 1665–1672, doi: 10.2106/JBJS.G.00693.
16.
RyzewiczM.WolfJ. M. (2006) Trigger digits: Principles, management, and complications. Journal of the American Society for Surgery of the Hand31(1): 135–146, doi: 10.1016/j.jhsa.2005.10.013.
SbernardoriM. C.BandieraP. (2007) Histopathology of the A1 pulley in adult trigger fingers. Journal of Hand Surgery, European Volume32(5): 556–559, doi: 10.1016/J.JHSE.2007.06.002.
19.
TurowskiG. A.ZdankiewiczP. D.ThomsonJ. G. (1997) The results of surgical treatment of trigger finger. Journal of the American Society for Surgery of the Hand22(1): 145–149, doi: 10.1016/S0363-5023(05)80195-9.
20.
WangJ.ZhaoJ. G.LiangC. C. (2013) Percutaneous release, open surgery, or corticosteroid injection, which is the best treatment method for trigger digits?Clinical Orthopaedics Related Research471(6): 1879–1886, doi: 10.1007/s11999-012-2716-6.
21.
WojahnR. D.FoegerN. C.GelbermanR. H.CalfeeR. P. (2014) Long-term outcomes following a single corticosteroid injection for trigger finger. Journal of Bone and Joint Surgery, American Volume96(22): 1849–1854, doi: 10.2106/JBJS.N.00004.
