Trigger finger

[3][2] While often referred to as a type of stenosing tenosynovitis (which implies inflammation) the pathology is mucoid degeneration.

However, recent publications indicate that diabetes and high blood sugar levels increases the risk of developing trigger finger.

The triggering more often occurs while gripping an object firmly or during sleep when the palm of the subject’s hand remains closed for an extended period of time, presumably because the enlargement of the tendon is maximum when the finger is not being used.

[10] Treatment consists of injection of a corticosteroid such as methylprednisolone often combined with a local anesthetic (lidocaine) at the A1 pulley in the palm.

Injection of the tendon sheath with a corticosteroid is effective over weeks to months in more than half of people.

On occasion, triggering does not resolve until a slip of the FDS (flexor digitorum superficialis) tendon is resected.

[10] One study suggests that the most cost-effective treatment is up to two corticosteroid injections followed by open release of the first annular pulley.

[14] In some trigger finger patients, tenderness is found in the dorsal proximal interphalangeal (PIP) joint.

Dorsal PIP joint tenderness is more common in trigger fingers than previously thought.

Therefore, patients with pre-existing PIP tenderness should be informed about the possibility of sustaining residual minor pain for up to 3 months after surgery.