Trigger finger

With a firm determination to develop new treatment approaches by harnessing current technologies, an innovative treatment approach called ultrasound-guided percutaneous trigger finger release has been invented. This approach provides convenience, cost-saving, accuracy, safety, and rapid recovery for patients with trigger fingers.

Trigger finger, also known as stenosing tenosynovitis, occurs when there is a size disproportion between a flexor tendon and its tendon sheath. Usually, when we flex or stretch a finger, the tendon glides smoothly through the tendon sheath, allowing optimal movement. However, when the tendon or its sheath thickens and tightly constricts on the tendon, the affected finger will no longer have a smooth flexion movement.

There are four grades of trigger finger symptom severity: pain, catching, locking, and contracture. In the early stage, tendon sheath inflammation leads to soreness at the base of the affected finger on the palm side, particularly during finger movement. Catching or locking does not typically occur at this stage. As the condition progresses, the thickened tendon sheath further restricts tendon movement, resulting in a catching during finger flexion. Finger locking, characterized by the inability to fully flex the finger or frozen finger in a bent position, can occur. Patients may need the help of their other hand to straighten the affected finger. If left untreated, the condition may lead to knuckle contracture, further complicating treatment.

Risk factors for trigger fingers include age and occupations requiring frequent finger use. Thickening of the tendon sheath is a natural response of tissues subjected to repetitive stress due to prolonged overuse in everyday tasks. Other medical conditions, such as diabetes, rheumatoid arthritis, and thyroid disorders, can also increase the risk of developing a trigger finger.

Trigger finger treatment should start with non-surgical remedies. These include rest, appropriate hand exercises, medications, splinting, physical therapy, cold or warm compress, acupuncture, and steroid injections. If the condition persists or recurs, consider surgical treatment. The surgical procedure involves cutting open the affected tendon sheath to allow free movement of the tendon. Two surgical procedures are available for trigger finger treatment: open surgery and percutaneous needle release.

Recent technological advances have made ultrasound machines widely available for assessing the severity of the trigger fingers. These machines can accurately locate the affected tendon sheaths and vital nearby structures, such as blood vessels and nerves. The ultrasound-guided percutaneous needle release has shown promising results. It is an outpatient procedure with no need to discontinue oral anticoagulants. Treatment of a finger typically takes about five minutes, requiring no pain medication post-surgery. Without an open wound, patients have a fast recovery and can wash their hands or take a bath as soon as 24 hours after the procedure.