TRIGGER finger describes a finger that is stuck in a bent position. The finger may bend or straighten with a painful snap.
The condition is caused by stenosing tenosynovitis, which is inflammation of the tendon sheath that surrounds the finger. This narrows the space within the sheath where the tendon passes through, causing pain and difficulty in movement.
Depending on the severity of the disease, patients can present differently. At the early stages, the patient will complain of pain in the finger. As the disease progresses, there will be difficulty in moving the finger, which is usually accompanied by a snap, like a trigger being pulled and released.
This usually becomes worse after prolonged resting of the affected finger. In the late stage, the affected finger may be locked in a bent position.
Trigger finger is not an infectious disease. Diabetes mellitus, gout, inflammatory arthritis, hypothyroidism, rheumatoid arthritis and sarcoidosis are associated with this condition. However, there are congenital cases in newborns as well.
TREATMENT
In early stages, symptoms may subside after rest and treatment like massage and heat therapy.
Some patients may need steroid injections. However, repeated steroid injections are not advisable. Symptoms that are not fully relieved by steroid injections are an indication that the disease is at a more advanced stage.
There are also potential adverse effects from repeated steroid injections like tendon ruptures, infections, thinning of the skin and skin discolouration.
Severe cases that fail conservative treatment require surgical intervention. This involves making a small incision at the palm to release the tightened tendon sheath.
This can be done under local anaesthesia or as a daycare procedure. It's a simple and safe surgery in professionalhands.
The risk of damage to surrounding structures like nerves and tendons, infection and prominent scarring is low.
If left untreated, trigger finger may cause partial handicap. The affected finger may become permanently stuck in a bent or straightened position. As a result, doing chores with the affected hand becomes difficult.
* The writer is a specialist in orthopaedics at Pantai Hospital Cheras.