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J Am Acad Orthop Surg, Vol 9, No 4, July/August 2001, 246-252.
© 2001 the American Academy of Orthopaedic Surgeons
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Trigger Digits: Diagnosis and Treatment

Miguel J. Saldana, MD

Dr. Saldana is in private practice with Hand and Microsurgery Associates, San Antonio, Tex.

Reprint requests: Dr. Saldana, Hand and Microsurgery Associates, Nix Medical Center, Suite 809, 44 Navarro, San Antonio, TX 78229.

Stenosing tenosynovitis of the thumb and fingers is a very common problem seen by the primary-care physician, the orthopaedic surgeon, and the hand surgeon. Primary stenosing tenosynovitis is usually idiopathic and occurs more frequently in middle-aged women than in men, but can be seen even in infancy. Secondary stenosing tenosynovitis of the digits can occur in patients with rheumatoid arthritis, diabetes mellitus, gout, and other disease entities that cause connective tissue disorders. The diagnosis of triggering digits is generally not subtle and can be made on the basis of an adequate clinical examination. Classification according to the type of tenosynovitis and the time from onset of symptoms may be prognostically significant and may also affect the treatment outcome. As many as 85% of triggering fingers and thumbs can be treated successfully with corticosteroid injections and nonsteroidal anti-inflammatory drugs. Surgical release is generally indicated when nonoperative treatment fails. Percutaneous A1 pulley release can now be performed safely as an office procedure.




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S. B. Fleisch, K. P. Spindler, and D. H. Lee
Corticosteroid Injections in the Treatment of Trigger Finger: A Level I and II Systematic Review
J. Am. Acad. Ortho. Surg., March 1, 2007; 15(3): 166 - 171.
[Abstract] [Full Text] [PDF]


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