Trigger Finger

 

Conservative management options prior to surgery:

1. Activity modification/NSAIDs
2. Hand Therapy
3. Splinting
4. Steroid injection relieves the pain and triggering in about 70% of cases, but the success rate is lower in people with diabetes. A second injection is sometimes helpful, but surgery may be needed if triggering persists.

 

When to Refer for Surgery:

• Uncomplicated trigger finger failing to respond to conservative measures (following a trial of up to 2 steroid injections if the first injection gives some benefit)

• Trigger finger in a patient with Diabetes – Following a trial of 1 steroid injection

• Locked trigger finger (in either flexion or extension)

AND· Patient wishes to undergo surgery

If symptoms fail to resolve, or there are extenuating circumstance that lead to a patient deciding against injection, then the next line of treatment may be either an open or percutaneous release of the constricted pulley (high evidence).

Recurrence of triggering after surgery is uncommon.

 

References:

1. British Society Surgery of the Hand – Evidence for Surgical Treatment (BEST) Evidence based management of adult trigger digits, October 2016.  

 

 

Date reviewed                     13/08/2024

Next review due                  13/08/2026

Sifter name                          Dr Rebecca Hopkins

 

Version No. 2.1