Trigger finger is diagnosed based on patient’s complaints, medical history and clinical examination.

Patients complain of pain and discomfort at the base of the finger or thumb where they join the palm. They may have locking of their affected digit when bending their fingers. There is difficulty in straightening the locked finger. They may also have a painful nodule at the base of their affected finger which is tender to local pressure.

When the finger begins to trigger or lock, the patient may think the problem is at the middle knuckle of the finger or the tip knuckle of the thumb, since the tendon that is locking is the one that moves these joints.

Treatment of the trigger finger may be conservative or surgical. The goal of treatment is to eliminate the catching or locking and allow full movement of the finger or thumb without discomfort.

Conservative treatment consists of:

• Anti-inflammatory painkillers to reduce pain and swelling. Swelling around the flexor tendon and tendon sheath must be reduced to allow smooth gliding of the tendon.
• Finger splint gives rest to the affected finger and reduces pain.
• Activity modifications also help to reduce swelling.
• An injection of steroid into the area around the tendon and pulley is often effective in relieving the trigger finger/thumb by reducing swelling and locking.

Surgery may be recommended if conservative treatment does not relieve the symptoms or patient has a painfully locked trigger finger.

This surgery of trigger finger release is performed as a day-care surgery under simple local anaesthesia.

The aim of this surgery is to open the pulley at the base of the finger so that the tendon can glide more freely. A tiny transverse or vertical skin incision is made close to the base of the affected digit. The A 1 pulley is exposed and released to free the flexor tendons. Then the flexor tendons are examined thoroughly for any swelling, nodularity or catching against any tissue. Once they are confirmed to be freely mobile without any friction, the wound is closed with simple sutures.

Sterile dressing is applied and a compression bandage is given. Patients are advised to keep hand elevated and mobilise their fingers.

Active motion of the finger generally begins immediately after surgery. Normal use of the hand can usually be resumed once comfort permits. Some patients may feel tenderness, discomfort, and swelling at the surgical site for 4 to 6 weeks. Occasionally, hand therapy is required after surgery to regain better use.