lso called stenosing tenosynovitis
Pathology
Trigger finger is caused by irritation of the flexor tendon sheath of the fingers, which can have various origins. The flexor tendons glide along the finger within a canal reinforced by rings called pulleys. To facilitate smooth movement, the tendons are surrounded by a synovial sheath.
The presence of a nodule on the tendon can interfere with its gliding within the sheath during finger movements. Initially, there may be pain or morning stiffness when moving the affected finger, which usually improves with activity. As the conflict progresses, symptoms become persistent, followed by intermittent catching or locking characteristic of the condition. In advanced cases, the finger may become stuck and require the use of the other hand to unlock it. The thumb and ring finger are most frequently affected.
Examination
The diagnosis is usually based on the clinical history and physical examination of the hand. In uncertain cases, ultrasound can be used to confirm the presence of the condition.
Treatment
Non-surgical
In early stages, a cortisone injection into the flexor tendon sheath is commonly performed. Pain at the injection site may temporarily increase for two to three days after the procedure.
Surgical
If symptoms persist or recur, surgery may be required. The goal is to eliminate the conflict between the flexor tendon and the first pulley of the digital canal by releasing the pulley. The catching or locking disappears immediately after surgery, while any preexisting limitation of mobility may take several weeks to resolve.
