Hand Surgeons Review Trigger Finger Treatment
In this review article hand surgeons from the University of Colorado Health Sciences Center in Denver discuss what causes trigger finger and what to do about it. Both conservative care and surgery are explained in detail. What to expect and types of problems that can occur are also presented.

Usually trigger finger is a mechanical problem. It can be caused by a tendon that's too large for the pulley mechanism it slides through. Or sometimes the outer covering over the tendon is too tight. The tendon can't slide and glide normally.

Trigger finger can also occur as a result of other conditions. Carpal tunnel and trigger finger often develop at the same time in the same patient. Endocrine and metabolic diseases can be the cause of both. Patients with systemic diseases like rheumatoid arthritis and diabetes have a higher risk of trigger finger.

Whatever the cause of trigger finger treatment is usually the same. First nonsteroidal antiinflammatory drugs (NSAIDs) are used. Splinting may help. Steroid injections are also common. Patients get long-term relief with one to three injections.

When all else fails the patient may want to think about having surgery. The surgeon makes a small incision in the palm of the hand. The pulley is cut. In most cases there aren’t any problems for the patient afterwards. The authors do review the complications that can occur with surgical treatment for this problem. Releasing the wrong pulley and nerve injury are uncommon but serious side effects of this operation.
Mark Ryzewicz, MD, and Jennifer Moriatis Wolf, MD. Trigger Digits: Principles, Management, and Complications. In The Journal of Hand Surgery. January 2006. Vol. 31A. No. 1. Pp. 135-146.