Trigger finger is a disease which is caused by the stiffness of the flexor tendon moving in A1 pulley, which is one of the components of the pulley system of the hand, as a result of stuck due to different etiological factors, difficulty in opening or not being able to open the finger and pain.
The disease is called a trigger finger because the tendon is freed from congestion suddenly after the insertion, and the sudden opening of the finger throws it like a trigger.
Trigger fingers can be seen in all fingers but most commonly in the thumb, and can be seen in infancy, childhood and adult age groups.
If it occurs during infancy and early childhood, it is called the congenital trigger finger and affects the same proportion of female and male gender. Trigger finger disease that develops during childhood, followed and untreated, will cause flexion contracture in the fingers. Mucopolysaccharidosis, Hurler’s syndrome, viral infections, anatomical variations should be investigated in the etiology of trigger finger especially in multiple finger involvement in childhood. Splitting, follow-up and stretching exercises can be performed in the early period of treatment. However, in patients who do not respond to conservative treatment, surgical treatment should not be delayed to prevent joint contracture.
Repetitive micro-traumas and inflammation and tendon sheath damage due to pressure are considered in the etiology of trigger finger in adults. Most of the pressure occurs at the A1 pulley level, which explains why it occurs most often at this level.
Anamnesis and clinical examination are essential for the diagnosis of a trigger finger. The palpation of painful nodules at the level of A1 pulley is detected. Stuck and triggered are monitored. If ultrasound is performed to support the diagnosis, the thickening of the pulley will be seen.
Seroid injection into the tendon sheath is one of the first-line treatments. However, repeated injections should be avoided due to tendon destruction, tissue atrophy, and skin discoloration. Patients with long-standing symptoms have a low chance of success.
Splitting is performed to prevent movement and is continued for 6-10 weeks. It provides regression of symptoms. However, likewise, patients with long-term complaints have a low chance of success.
In cases where there is no response from conservative treatment or when the finger remains locked, surgical treatment should be planned so that surgery is considered the gold standard for the treatment of a trigger finger.