Trigger Finger

What is trigger finger?

Trigger finger is a condition that involves clicking or locking of the fingers. The formal name is stenosing tenosynovitis.

How does trigger finger occur?

The flexor tendons of the fingers travel through a series of tunnels as they go towards the fingertip. The purpose of the tunnels or pulley is to hold the tendons close to the bone to provide mechanical advantage and strength when making a fist. In trigger finger, there is narrowing of the A1 pulley which causes the triggering as the tendon becomes stuck under the pulley.

Diagnosing trigger finger

Patients with trigger finger experience clicking, locking, or sticking of the finger when making a fist. This is often worse in the morning and may slowly improve over the course of the day. Occasionally, patients must manually extend the finger to make it move again. Patients may notice a lump in their palm. The most common fingers involved are the thumb, middle and ring finger. Patients can have multiple fingers involved at the same time. Trigger finger is more common in diabetes, repetitive motion activities gout and arthritis.

Nonsurgical treatment of trigger finger

The initial treatment of trigger finger is to avoid the offending activity. Therapy and splinting may be helpful but usually does not cure the condition. Often, corticosteroid injection can help. Corticosteroid injections cure trigger finger between 50-75% of the time. They are much less effective in diabetes and must be used cautiously as they can increase blood sugars in patients with elevated HBA1C levels.

Surgical treatment for trigger finger

Surgery is very effective for trigger finger. The surgery is performed under a local anesthetic. The surgery involves dividing the A1 pulley to allow the tendons to glide more freely. Invisible sutures are used, and patients need to keep the wound dry and be careful about one week to allow for wound healing. Most patients are using the hand normally within 2-3 week and the recurrence rate is extremely low. Occasionally therapy is needed if patients become stiff but full motion is usually obtained.

Schedule a consultation

Board-certified and fellowship-trained hand surgeon Dr. Kavi Sachar is widely regarded as one the nation’s leading experts on trigger finger. Dr. Sachar has three office locations in Vail, Aspen, and Frisco, Colorado. If you or a family member suffer from trigger finger, contact Sachar today. Dr. Sachar is part of the world-renowned Steadman Clinic. Dr. Sachar and his team are here to help.