Trigger Finger

Jessy Widiyanti, S.Ked

Kiki Ayu Zuliani, S.Ked
Kiki Rizki Elvandri, S.Ked
Lisdyana Agustin, S.Ked

Dr. Aswedi Putra, Sp.OT, FICS

Universitas Malahayati
Trigger Finger
also known as stenosing tenosynovitis of the digital flexor or trigger thumb

a finger that becomes 'locked‘ after it has been bent(flexed) towards

the palm. It is difficult to straighten out without pulling on it by the
other hand. Initially the finger may just intermittently catch.

One or more fingers may be affected. Most commonly affects ring

finger or thumb.
It is one of the most common pathologies presented at hand
clinics with..
- a lifetime risk of 2.6% within the general population, Around 2 in
100 people develop trigger finger
- significantly higher amongst diabetics and females
- prevalent in only 0.3% of children
Etiology
Etiology of Trigger finger is a multicausal, idiopathic, without a clear
cause and usually occurs due to repeated, automated actions in non-
physiological position during long time.
Movements, such as handling the computer mouse or working on a
factory production line, affect the muscles and ligaments and when they
persist for a long time.

Some trigger fingers are associated with medical conditions such as

rheumatoid arthritis, gout, and diabetes.

It is thought to be due to some inflammation which causes swelling of a

tendon or tendon sheath.
 Patophisiology
• A tendon is a strong tissue that attaches a muscle to a bone. In this case
the tendon comes from a muscle in the forearm. It passes through the
palmar. It attaches to the finger bone. The muscle pulling on this tendon
bends (flexes) the finger towards the palm
• A tendon sheath is like a tunnel that covers and protects parts of a tendon.
Normally, the tendon slides easily in and out of the sheath as you bend
and straighten the finger. In trigger finger the tendon can slide out of the
sheath when you bend your finger, however, it cannot easily slide back.
The finger then remains bent(flexed) unless you pull it straight with your
other hand.
Risks factor
• people aged over 40
• Trigger finger affects women more than man
• Right hand was more affected with Trigger finger
• but the affected finger and hand dominance are
not always correlated
• Have rheumatoid arthritis or diabetes.
• Local trauma to the palm/base of the finger
• High-risk professions include the workers on the
production line, workers by a computer, miners,
butchers, musicians
Diagnosis
The condition is characterised by
• the restricted motion of the digit
• painful clicking
• subsequent locking of the digit

This usually occurs a result of a failure in the first annular (A1)

pulley gliding mechanism, due to a discrepancy in the diameter
between the flexor tendon and its inflamed, hypertrophic
sheath.

It is a typically straightforward diagnosis that it is initially

managed with steroid injections.
 Symptoms
• May start with discomfort felt at the base of the finger
• Sometimes there is mild pain and/or a small swelling at the base of
the affected finger. A nodule may sometimes be found in this area.
• Tender to local pressure
• The digit may need to be straightened with pressure from the
opposite hand.
• Clicking sound when the digit pulled straight, or locking in a bent
position, This clicking may be worse in the morning.
• Stiffness, especially in trigger thumb where movement at the end
joint is reduced.
Trauma and Orthopaedics Department of West
Suffolk Hospital. November 2017

Pecar, Muris., Avdić., Dijana., Džemal, Pecar.

2011. Evaluation of the conservative treatment
of Trigger finger by local instillation of
corticosteroids. Journal of Health Sciences; 1(3)