by Dr.ssa Roberta Nolli – Orthopedics and Traumatology Specialist with Specialization in Hand Surgery and Reconstructive Microsurgery – Columbus Clinic Centre.
WHAT IS IT?
Trigger finger is a condition that affects the flexor tendons of the hand fingers. It is a very common disorder occurring at all ages among both males and females
It consists of an inflammation (tenosynovitis) which leads to an increase in the volume of the tendon causing peritendinous effusion and consequent entrapment of the affected tendon inside the digital canal within which it flows.
The mechanical impingement at the level of the A1 pulley (fibrous thickening of the digital canal at the base of the finger) results in soreness at the base of the finger and subsequent “snap” during flexion-extension movements.
HOW IS IT TREATED?
The treatment of trigger finger depends on the stage of the condition:
1) shortly after the onset of symptoms and in the initial stages, it can be managed conservatively: this includes immobilization, intermittent use of specially designed finger splints, short physical therapy sessions (e.g. tecar therapy, high level laser therapy, Cryotherapy).
2) In the intermediate stages, there being no contraindications weighing against any associated conditions, it is possible to carry out one or maximum two peritendinous corticosteroid infiltrations at the flexor tendons of the A1 pulley, only following a targeted musculoskeletal ultrasound to ensure that there is no degeneration of the tendon fibers. This option allows for a notable relief of painful symptoms and actually improves the tendon gliding. However, the relief can be temporary, so when the problem returns, patients are usually recommended undergoing surgery.
3) In the more advanced stages, surgical treatment is the only option.
WHAT DOES THE SURGICAL PROCEDURE INVOLVE?
The surgery, when necessary, is performed under local anesthesia and involves a small palmar skin incision at the base of the finger in the longitudinal section of the A1 pulley, aimed at releasing the flexor tendons in order to restore proper gliding.