Trigger finger is a “snapping” or “locking” condition affecting any digit of the hand. The triggering results when the finger goes from a flexed to an extended position. During this action, the tendon will lock up at a certain point, requiring greater force to be applied to straighten the digit. When this happens, there’s an audible or palpable click that happens. In some cases, the finger must be straightened manually with the other hand, also producing the clicking sensation.
Trigger finger is related to an inflammatory condition involving one of the flexor tendons. When the tendon is inflamed within its tunnel, a nodule can develop. This nodule, in turn, may get caught underneath a ligamentous arch as the tendon tries to glide through its normal path. Aside from the clicking sensation, other symptoms can include pain and stiffness. If left untreated for a prolonged period of time, a permanent flexed posture of the finger may result. This is especially true in the growing child.
Surgery to correct a trigger finger is relatively straightforward. A small incision is placed at the base of the finger where the locking is occurring. The tight ligament (ie, pulley) is released with instant relief of the symptoms. This is typically an outpatient procedure and takes no more than 10 minutes per involved finger. In some cases, a trial of steroid injection is possible to help relieve the triggering without surgery, but there is still a high rate of recurrence with this option. It is not recommended in children.
