Trigger finger

21:54 - 4 May , 2021

Disease

What is Trigger finger?

Also known as stenosing tenosynovitis, trigger finger is a condition in which a finger of the hand blocks when it is flexed due to inflammation in the tendon responsible for facilitating flexor movement, causing pain in the finger and the palm of the hand. It can cause a spring-like noise or squeak when stretched or flexed, but in a severe case, the finger locks in the flexed position, possibly requiring a surgical procedure to free it. The origin of trigger finger is unknown, but a series of risk factors have been identified, such as: 
  • It is more common in women.
  • Suffering from arthritis
  • Being diabetic.
  • Playing musical instruments that are demanding on the fingers.
  • Activities or jobs that require repetitive movements or static positions of the hands for a long time.
  • Having undergone surgery for carpal tunnel syndrome.
Four levels of severity have been established: 
  • Occasionally causes mild discomfort.
  • Recurrent blockages occur and pain begins.
  • Locks are frequent and the pain grows, but the blockage can still be reversed.
  • The finger is trapped and it is not possible to unlock it except with surgery.

Symptoms

  • Finger numbness, especially after long periods of immobility, such as when waking up in the morning.
  • Noise or grinding noise when moving the finger.
  • Nodule in the palm of the hand, at the beginning of the injured finger.
  • Reversible finger lock, so it can snap back into place with a squeak.
  • Permanent lock in the flexed position and cannot be unlocked.
Generally, this condition does not occur in a single finger, but several are affected at the same time, even in different hands.

Diagnosis and treatment

Once your doctor analyzes your symptoms and clinical history, they will perform a physical examination, in which you will be asked to perform specific movements with the affected fingers to see the magnitude of the pain, the inflammation, and the degree of blockage. The treatment plan will depend on the severity of the symptoms and whether there is an underlying disease that may be causing trigger finger, but anti-inflammatories and pain killers are usually prescribed. They will recommend rest and that you avoid making repetitive movements or performing prolonged grips, they will prepare a personalized stretching program, and you will need to use a night splint that keeps your fingers stretched while you sleep. If the symptoms are very intense or that conservative treatment does not yield good results, there are other options such as: 
  • Steroids injected directly into the tendon.
  • Percutaneous release via ultrasound-guided needle insertion.
  • Surgical procedure to release the part of the injured tendon through a precise cut.
At the Orthopedics and Traumatology Center, we seek to improve the lives of patients restricted or immobilized by musculoskeletal disorders or injuries. We specialize in the care of the locomotor system by integrating the latest medical, biological, and technological advances, in strict adherence to the highest international standards of patient care.

Fuentes:

  • lesionesdemano.com
  • middlesexhealth.org
  • medlineplus.gov
  • mayoclinic.org
  • topdoctors.es
  • medigraphic.com
  • Carrasco; OrtizO; Pérez; GarmendiaR; Márquez; Espriella C; et al. Evaluación de resultados clínicos postoperatorios a corto y largo plazo de liberación percutánea con aguja vs técnica abierta de dedo en gatillo. Acta Ortop Mex. 2019;33(6):357-361. doi:10.35366/93340.
  • Molina OJE, Gargollo OC, Campos SEI, et al. Tenosinovitis estenosante de los dedos de la mano (dedo en gatillo). Acta Med. 2020;18(4):424-426. doi:10.35366/97273.
  • Migoya-Nuño A, Fraind-Maya G, Loyo-Soriano LE. Pulgar en gatillo, pulgar en resorte, o tenosinovitis estenosante del pulgar pediátrico. Acta Pediatr Mex. 2021;42(2):89-91.
  • De la Parra-Márquez ML, Tamez-Cavazos R, Zertuche-Cedillo L, et al. Factores de riesgo asociados a tenosinovitis estenosante. Estudio de casos y controles. Cir Cir. 2008;76(4):323-327.

						
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