5-Minute Clinical Consult
Trigger Finger (Digital Stenosing Tenosynovitis)
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Basics
Description
A clicking, snapping, or locking of a finger/thumb with extension ± associated pain
Epidemiology
Incidence
- Adult population: 2–3% of adults (1)
- Rare in children
- Thumb is predominant digit.
- Predominant age
- Adult form typically presents in the 5th and 6th decades of life.
- Predominant sex
- Children: female = male
- Adults: female > male (6:1)
Prevalence
Lifetime prevalence in the general population is 2.6%.
Pediatric Considerations
- Surgery is often more complicated for children with a trigger finger (as opposed to a trigger thumb).
- Release of the A1 pulley alone is often insufficient; other procedures may be necessary.
Etiology and Pathophysiology
- Narrowing around the A1 pulley from inflammation, protein deposition, or thickening of the tendon itself. Prolonged inflammation leads to fibrocartilaginous metaplasia of the tendon sheath.
- If flexor tendon becomes nodular, the triggering phenomenon is worse because the nodule has difficulty passing under the A1 pulley.
- Because intrinsic flexor muscles are stronger than extensors, the finger can get stuck in the flexed position.
- No clear association with repetitive movements
Risk Factors
- Diabetes mellitus
- Rheumatoid arthritis
- Hypothyroidism
- Mucopolysaccharide disorders
- Amyloidosis
General Prevention
Most cases are idiopathic, and no known prevention exists; no clear association with repetitive movements
Commonly Associated Conditions
- De Quervain tenosynovitis
- Carpal tunnel syndrome
- Dupuytren contracture
- Diabetes mellitus
- Rheumatoid arthritis
- Hypothyroidism
- Amyloidosis
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
Description
A clicking, snapping, or locking of a finger/thumb with extension ± associated pain
Epidemiology
Incidence
- Adult population: 2–3% of adults (1)
- Rare in children
- Thumb is predominant digit.
- Predominant age
- Adult form typically presents in the 5th and 6th decades of life.
- Predominant sex
- Children: female = male
- Adults: female > male (6:1)
Prevalence
Lifetime prevalence in the general population is 2.6%.
Pediatric Considerations
- Surgery is often more complicated for children with a trigger finger (as opposed to a trigger thumb).
- Release of the A1 pulley alone is often insufficient; other procedures may be necessary.
Etiology and Pathophysiology
- Narrowing around the A1 pulley from inflammation, protein deposition, or thickening of the tendon itself. Prolonged inflammation leads to fibrocartilaginous metaplasia of the tendon sheath.
- If flexor tendon becomes nodular, the triggering phenomenon is worse because the nodule has difficulty passing under the A1 pulley.
- Because intrinsic flexor muscles are stronger than extensors, the finger can get stuck in the flexed position.
- No clear association with repetitive movements
Risk Factors
- Diabetes mellitus
- Rheumatoid arthritis
- Hypothyroidism
- Mucopolysaccharide disorders
- Amyloidosis
General Prevention
Most cases are idiopathic, and no known prevention exists; no clear association with repetitive movements
Commonly Associated Conditions
- De Quervain tenosynovitis
- Carpal tunnel syndrome
- Dupuytren contracture
- Diabetes mellitus
- Rheumatoid arthritis
- Hypothyroidism
- Amyloidosis
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