What is Trigger Finger?
Trigger finger, also known as stenosing tenosynovitis, is a condition in which a finger movement gets stuck in a bent position, causing it hard to be straighten. This abnormal movement mimics the movement of a trigger being pulled and released – fingers may produce a snap or jerk when it is bent or straighten, thus the name trigger finger.
This condition occurs due to the inflammation of a structure that wraps the tendon, known as a pulley. A pulley appears like a small bridge and plays a role to hold the tendon against the bone of the fingers, preventing a “bowstringing” shape when a finger is bent. Usually, trigger finger involves the pulley that is located at the base of the finger, the other side of the knuckle. It most commonly occurs in the ring finger although any finger can be affected.
What are the signs and symptoms?
Chief complaint is usually pain and stiffness of the affected finger, especially in the morning. Patients may also complain of a hard mass on their palms that become tender to touch or pressure. Complaints will be followed by functional abnormalities as the fingers are not easy to be straighten and bent while gripping or grabbing an object. In severe cases, fingers may become locked in a bent position. Trigger finger can occur in any finger, including the thumb, multiple fingers simultaneously, as well as fingers of both hands.
What are the triggers?
Cause of this disease is poorly known, but one of the possibilities is the repeated use of fingers as well as a job or activity that involves repetitive gripping movements. Middle-aged patients – 40-50 years-old, and females are more susceptible to this disease.
What to do?
Treatments can be done with non-surgical manipulation or adjustments or with surgical procedures. Non-surgical treatments may include applying warm compresses early in the morning prior to activities, taking painkillers, doing stretches with particular techniques, and applying finger sling at night. If these adjustments do not seem to relieve the symptoms after some time, an injection can be given to alleviate the inflammation of the pulley.
Surgical treatments can be an option if symptoms persist after doing various conservative treatments mentioned before. Surgery is done to “cut” the thick and inflamed pulley – giving the tendon more space. Surgery is classified as minor and done while the patient is fully awake, known as the fully awake hand surgery (FAHS). Post-surgery recovery and rehabilitation program is mandatory and should be followed with compliance to train the previously “stuck” finger so that it will be normally recovered.
Written by Dr. Teddy Prasetyono and dr. Amila Tikyayala
Division of Plastic Surgery, Department of Surgery
Dr. Cipto Mangunkusumo Hospital / Faculty of Medicine, Universitas Indonesia
Translated by Illona Andromeda, M.D.