Trigger Finger/ Thumb

This is a common hand condition characterised by pain and clicking of the digit. Sometimes the finger gets stuck in the palm (locking) and the patient has to pull it straight. The cause is related to degenerative change in part of the palmar pulley system which undergoes wear and tear thus narrowing. As a result the tendon fails to slide smoothly in its tunnel; instead triggering or locking occurs

Patients with diabetes are frequently affected but it is important to note that most patients with triggering are not diabetic.

Treatment

Steroid injections into the palm around the pulley has a success rate of 70-80 %. This is lower for diabetics.

If steroid injections fail then surgical decompression is offered. This involves a small cut in the palm and release of the pulley at the mouth of the tendon sheath. A light dressing is applied to the wound for 10-14 days and the hand is initially elevated whilst maintaining good finger movements.