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Trigger Finger, Sports Medicine

Miranda Gordon-Zigel, MD and Rahul Kapur, MD, CAQSM Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Also called flexor tenosynovitis

  • Type of stenosing tenosynovitis

  • Nodule on flexor tendon catching on first annular (A1) pulley

  • Can affect any digit; occasionally, multiple digits

  • Ring an...

DIAGNOSIS

HISTORY

  • Painful catching/clicking with finger flexion or extension

  • Pain over MCP; may refer to palm or proximal interphalangeal (PIP) joint

  • Digit may be locked, usually in flexion.

  • Stiffness dev...

TREATMENT

GENERAL MEASURES

  • Activity modification

  • Splinting of MCP joint at 10 to 15 degrees of flexion × 6 to 10 wk:

    • Reduces tendon motion in sheath

    • Allows resolution of surrounding synovitis

    • 93% with part...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

May see increased glucose level following steroid injection in diabetes 

PROGNOSIS

  • Excellent; over 90% symptom resolution with steroid or surgical...

REFERENCES

1
Lunsford D, Valdes K, Hengy S. Conservative management of trigger finger: a systematic review [published online ahead of print December 28, 2017]. J Hand Ther. doi:10.1016/j.jht.2017.10.01...

ADDITIONAL READING

  • Akhtar S, Bradley MJ, Quinton DN, et al. Management and referral for trigger finger/thumb. BMJ.  2005;331(7507):30–33.

  • Giugale J, Fowler J. Trigger finger: adult and pediatric t...

CLINICAL PEARLS

  • Clinical diagnosis by painful catching at MCP joint

  • Corticosteroid injection is safe and highly effective first-line treatment.

  • Surgical release provides excellent results when conservat...

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