Clinical management of trigger finger (TF): My approach

There are two parts to managing any medical condition: the components of the therapeutic plan and the patient. Our job is to tailor the plan to best suit that individual patient’s needs.

Trigger Finger (TF), also known as stenosing tenosynovitis, is one of the most common causes of hand or digit pain seen at the Hand Clinic. Inflammatory changes are not seen histologically, but the tendon sheath (tendovagina) is thickened therefore more apt to be called tenovaginitis. It is basically a mechanical mismatch due to inflamed flexor tendons (flexor digitorum superficialis and profundus) and the thickened overlying retinacular pulley system (mostly theA1pulley) constricting them as they to go through the base of the digit. This restriction leads to friction, progressive tendon thickening, nodule formation, and the classic clinical presentation of painful digital catching, snapping, or locking inflexion.