What is it?
 Trigger
Finger describes a condition in which the finger gets caught
either in bringing it down (flexion) or in straightening it
out (extension). At first it may be painless and intermittent,
but progressively gets painful and occurs with regularity.
The pain is located at the base of the involved finger. True
locking may occur which requires the opposite hand to break
it free. At first the trigger finger is little more than an
annoyance, which gradual progresses to interfere with most
activities of daily living.
Cause
Trigger finger usually results from an overuse phenomenon.
It comes on gradually. It usually is worse first thing in the
morning. Repeated vibratory forces in the palm of the hand
have been implicated.
Diagnosis
The diagnosis usually can be made on the basis of a good history
and physical exam. Oftentimes the finger will not “lock” in
the doctor’s office, however tenderness can be palpated
(felt) at the base of the involved finger.
Treatment
Treatment begins with conservative therapy. If an offending
agent is identified, it is removed from daily activities. Non-steroidal
anti-inflammatory drugs (NSAID’s) are used to reduce
the inflammation in the palm of the hand. Your Orthopedic Surgeon
will inject a steroid solution directly into the tendon sheath
that is inflamed. Splinting of the metacarpal-phalangeal joint
(MCPJ) is sometimes used in severe cases. Surgery is usually
reserved for the refractory cases that remain symptomatic and
painful. The surgical procedure involves a 1-inch incision
to release the tight pulley under which the swollen tendon
traverses. This often takes less then 10 minutes and is done
as same-day surgery. The patient is encouraged to move the
fingers almost immediately post-operatively. Symptomatic relief
is immediate, and recurrence is very rare.
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