Trigger Finger Questions & Answers

1. Fam AG. Regional pain problems. Klippel JH, Dieppe PA, eds. Practical Rheumatology. London, England: Mosby; 1997.

2. AAOS. Trigger finger. AAOS Essentials of Musculoskeletal Care. 6th ed. Burlington, MA: Jones & Bartlett Learning; 2022.

3. Finnoff JT, Johnson W. Upper limb pain and dysfunction. Cifu DX, Eapen BC, Johns JS, Kowalske KJ, Lew HL, Miller MA, et al, eds. Braddom's Physical Medicine and Rehabilitation. 6th ed. Philadelphia: Elsevier; 2021. 715-26.

4. Bae DS. Pediatric trigger thumb. J Hand Surg Am. 2008 Sep. 33 (7):1189-91. [QxMD MEDLINE Link].

5. Kim HR, Lee SH. Ultrasonographic assessment of clinically diagnosed trigger fingers. Rheumatol Int. 2010 Sep. 30 (11):1455-8. [QxMD MEDLINE Link].

6. Bamroongshawgasame T. A comparison of open and percutaneous pulley release in trigger digits. J Med Assoc Thai. 2010 Feb. 93 (2):199-204. [QxMD MEDLINE Link].

7. Will R, Lubahn J. Complications of open trigger finger release. J Hand Surg Am. 2010 Apr. 35 (4):594-6. [QxMD MEDLINE Link].

8. Schramm JM, Nguyen M, Wongworawat MD. The safety of percutaneous trigger finger release. Hand (N Y). 2008 Mar. 3 (1):44-6. [QxMD MEDLINE Link]. [Full Text].

9. Masquijo JJ, Ferreyra A, Lanfranchi L, Torres-Gomez A, Allende V. Percutaneous trigger thumb release in children: neither effective nor safe. J Pediatr Orthop. 2014 Jul-Aug. 34 (5):534-6. [QxMD MEDLINE Link].

10. Schubert C, Hui-Chou HG, See AP, Deune EG. Corticosteroid injection therapy for trigger finger or thumb: a retrospective review of 577 digits. Hand (N Y). 2013 Dec. 8 (4):439-44. [QxMD MEDLINE Link]. [Full Text].

11. Rodgers WB, Waters PM. Incidence of trigger digits in newborns. J Hand Surg Am. 1994 May. 19 (3):364-8. [QxMD MEDLINE Link].

12. De Smet L, Steenwerckx A, Van Ransbeeck H. The so-called congenital trigger digit: further experience. Acta Orthop Belg. 1998 Sep. 64 (3):306-8. [QxMD MEDLINE Link].

13. Li Z, Wiesler ER, Smith BP, Koman LA. Surgical treatment of pediatric trigger thumb with metacarpophalangeal hyperextension laxity. Hand (N Y). 2009 Dec. 4 (4):380-4. [QxMD MEDLINE Link]. [Full Text].

14. Marks MR, Gunther SF. Efficacy of cortisone injection in treatment of trigger fingers and thumbs. J Hand Surg Am. 1989 Jul. 14 (4):722-7. [QxMD MEDLINE Link].

15. Breen TF. Wrist and hand. Steinberg GG, Akins CM, Baran DT, eds. Orthopaedics in Primary Care. 3rd ed. Baltimore: Lippincott Williams & Wilkins; 1999. 99-138.

16. Brinker MR, Miller MD. The adult hand. Fundamentals of Orthopaedics. Philadelphia: WB Saunders; 1999. 196-220.

17. Magee DJ, Manske RC. Forearm, wrist, and hand. Orthopedic Physical Assessment. 7th ed. St Louis: Elsevier; 2022. 482-577.

18. Miyamoto H, Miura T, Isayama H, Masuzaki R, Koike K, Ohe T. Stiffness of the first annular pulley in normal and trigger fingers. J Hand Surg Am. 2011 Sep. 36 (9):1486-91. [QxMD MEDLINE Link].

19. Hueston JT, Wilson WF. The aetiology of trigger finger explained on the basis of intratendinous architecture. Hand. 1972 Oct. 4 (3):257-60. [QxMD MEDLINE Link].

20. Sampson SP, Badalamente MA, Hurst LC, Seidman J. Pathobiology of the human A1 pulley in trigger finger. J Hand Surg Am. 1991 Jul. 16 (4):714-21. [QxMD MEDLINE Link].

21. Ryzewicz M, Wolf JM. Trigger digits: principles, management, and complications. J Hand Surg Am. 2006 Jan. 31 (1):135-46. [QxMD MEDLINE Link].

22. Kumar P, Chakrabarti I. Idiopathic carpal tunnel syndrome and trigger finger: is there an association?. J Hand Surg Eur Vol. 2009 Feb. 34 (1):58-9. [QxMD MEDLINE Link].

23. Grandizio LC, Beck JD, Rutter MR, Graham J, Klena JC. The incidence of trigger digit after carpal tunnel release in diabetic and nondiabetic patients. J Hand Surg Am. 2014 Feb. 39 (2):280-5. [QxMD MEDLINE Link].

24. Freiberg A, Mulholland RS, Levine R. Nonoperative treatment of trigger fingers and thumbs. J Hand Surg Am. 1989 May. 14 (3):553-8. [QxMD MEDLINE Link].

25. Griggs SM, Weiss AP, Lane LB, Schwenker C, Akelman E, Sachar K. Treatment of trigger finger in patients with diabetes mellitus. J Hand Surg Am. 1995 Sep. 20 (5):787-9. [QxMD MEDLINE Link].

26. Stahl S, Kanter Y, Karnielli E. Outcome of trigger finger treatment in diabetes. J Diabetes Complications. 1997 Sep-Oct. 11 (5):287-90. [QxMD MEDLINE Link].

27. Baumgarten KM, Gerlach D, Boyer MI. Corticosteroid injection in diabetic patients with trigger finger. A prospective, randomized, controlled double-blinded study. J Bone Joint Surg Am. 2007 Dec. 89 (12):2604-11. [QxMD MEDLINE Link].

28. Moriya K, Uchiyama T, Kawaji Y. Comparison of the surgical outcomes for trigger finger and trigger thumb: preliminary results. Hand Surg. 2005 Jul. 10 (1):83-6. [QxMD MEDLINE Link].

29. Leung OY, Ip FK, Wong TC, Wan SH. Trigger thumbs in children: results of surgical release. Hong Kong Med J. 2011 Oct. 17 (5):372-5. [QxMD MEDLINE Link].

30. Baek GH, Lee HJ. The natural history of pediatric trigger thumb: a study with a minimum of five years follow-up. Clin Orthop Surg. 2011 Jun. 3 (2):157-9. [QxMD MEDLINE Link]. [Full Text].

31. Moore JS. Flexor tendon entrapment of the digits (trigger finger and trigger thumb). J Occup Environ Med. 2000 May. 42 (5):526-45. [QxMD MEDLINE Link].

32. Moriya K, Uchiyama T, Kouda H, Kawaji Y. Acromegaly as a cause of trigger finger. Scand J Plast Reconstr Surg Hand Surg. 2009. 43 (4):236-8. [QxMD MEDLINE Link].

33. Drossos K, Remmelink M, Nagy N, de Maertelaer V, Pasteels JL, Schuind F. Correlations between clinical presentations of adult trigger digits and histologic aspects of the A1 pulley. J Hand Surg Am. 2009 Oct. 34 (8):1429-35. [QxMD MEDLINE Link].

34. Tung WL, Kuo LC, Lai KY, Jou IM, Sun YN, Su FC. Quantitative evidence of kinematics and functional differences in different graded trigger fingers. Clin Biomech (Bristol, Avon). 2010 Jul. 25 (6):535-40. [QxMD MEDLINE Link].

35. Lapidus PW, Guidotti FP. Stenosing tenovaginitis of the wrist and fingers. Clin Orthop Relat Res. 1972 Mar-Apr. 83:87-90. [QxMD MEDLINE Link].

36. Rhoades CE, Gelberman RH, Manjarris JF. Stenosing tenosynovitis of the fingers and thumb. Results of a prospective trial of steroid injection and splinting. Clin Orthop Relat Res. 1984 Nov. 236-8. [QxMD MEDLINE Link].

37. de Boer P, Buckley R, Hoppenfeld S. The wrist and hand. Surgical Exposures in Orthopaedics: The Anatomic Approach. 6th ed. Philadelphia: Wolters Kluwer; 2022. 197-276.

38. [Guideline] Huisstede BM, Hoogvliet P, Coert JH, Fridén J, European HANDGUIDE Group. Multidisciplinary consensus guideline for managing trigger finger: results from the European HANDGUIDE Study. Phys Ther. 2014 Oct. 94 (10):1421-33. [QxMD MEDLINE Link].

39. Murphy D, Failla JM, Koniuch MP. Steroid versus placebo injection for trigger finger. J Hand Surg Am. 1995 Jul. 20 (4):628-31. [QxMD MEDLINE Link].

40. Leow MQH, Zheng Q, Shi L, Tay SC, Chan ES. Non-steroidal anti-inflammatory drugs (NSAIDs) for trigger finger. Cochrane Database Syst Rev. 2021 Apr 14. 4:CD012789. [QxMD MEDLINE Link].

41. Patel MR, Bassini L. Trigger fingers and thumb: when to splint, inject, or operate. J Hand Surg Am. 1992 Jan. 17 (1):110-3. [QxMD MEDLINE Link].

42. Baek GH, Kim JH, Chung MS, Kang SB, Lee YH, Gong HS. The natural history of pediatric trigger thumb. J Bone Joint Surg Am. 2008 May. 90 (5):980-5. [QxMD MEDLINE Link].

43. Lee ZL, Chang CH, Yang WY, Hung SS, Shih CH. Extension splint for trigger thumb in children. J Pediatr Orthop. 2006 Nov-Dec. 26 (6):785-7. [QxMD MEDLINE Link].

44. Ogino T. Trigger thumb in children: current recommendations for treatment. J Hand Surg Am. 2008 Jul-Aug. 33 (6):982-4. [QxMD MEDLINE Link].

45. Sato ES, Gomes Dos Santos JB, Belloti JC, Albertoni WM, Faloppa F. Treatment of trigger finger: randomized clinical trial comparing the methods of corticosteroid injection, percutaneous release and open surgery. Rheumatology (Oxford). 2012 Jan. 51 (1):93-9. [QxMD MEDLINE Link].

46. Cardon LJ, Ezaki M, Carter PR. Trigger finger in children. J Hand Surg Am. 1999 Nov. 24 (6):1156-61. [QxMD MEDLINE Link].

47. Ashford JS, Bidic SM. Evaluation of pediatric trigger thumb in the Hispanic population at a southwest urban medical center. Plast Reconstr Surg. 2009 Oct. 124 (4):1221-1224. [QxMD MEDLINE Link].

48. Herren DB, Chung KC. Rheumatoid arthritis and other inflammatory arthropathies. Wolfe SW, Pederson WC, Kozin SH, Cohen MS, eds. Green's Operative Hand Surgery. 8th ed. Philadelphia: Elsevier; 2022. Vol 2: 2040-104.

49. Peters-Veluthamaningal C, Winters JC, Groenier KH, Jong BM. Corticosteroid injections effective for trigger finger in adults in general practice: a double-blinded randomised placebo controlled trial. Ann Rheum Dis. 2008 Sep. 67 (9):1262-6. [QxMD MEDLINE Link].

50. Nimigan AS, Ross DC, Gan BS. Steroid injections in the management of trigger fingers. Am J Phys Med Rehabil. 2006 Jan. 85 (1):36-43. [QxMD MEDLINE Link].

51. Fleisch SB, Spindler KP, Lee DH. Corticosteroid injections in the treatment of trigger finger: a level I and II systematic review. J Am Acad Orthop Surg. 2007 Mar. 15 (3):166-71. [QxMD MEDLINE Link].

52. Geiringer SR. Tendon sheath and insertion injections. Lennard TA, ed. Physiatric Procedures in Clinical Practice. Philadelphia: Hanley & Belfus; 1995. 44-8.

53. Kerrigan CL, Stanwix MG. Using evidence to minimize the cost of trigger finger care. J Hand Surg Am. 2009 Jul-Aug. 34 (6):997-1005. [QxMD MEDLINE Link].

54. Ring D, Lozano-Calderón S, Shin R, Bastian P, Mudgal C, Jupiter J. A prospective randomized controlled trial of injection of dexamethasone versus triamcinolone for idiopathic trigger finger. J Hand Surg Am. 2008 Apr. 33 (4):516-22; discussion 523-4. [QxMD MEDLINE Link].

55. Chambers RG Jr. Corticosteroid injections for trigger finger. Am Fam Physician. 2009 Sep 1. 80 (5):454. [QxMD MEDLINE Link].

56. Mol MF, Neuhaus V, Becker SJ, Jupiter JB, Mudgal C, Ring D. Resolution and recurrence rates of idiopathic trigger finger after corticosteroid injection. Hand (N Y). 2013 Jun. 8 (2):183-90. [QxMD MEDLINE Link]. [Full Text].

57. Rozental TD, Zurakowski D, Blazar PE. Trigger finger: prognostic indicators of recurrence following corticosteroid injection. J Bone Joint Surg Am. 2008 Aug. 90 (8):1665-72. [QxMD MEDLINE Link].

58. Carlson CS Jr, Curtis RM. Steroid injection for flexor tenosynovitis. J Hand Surg Am. 1984 Mar. 9 (2):286-7. [QxMD MEDLINE Link].

59. Godey SK, Bhatti WA, Watson JS, Bayat A. A technique for accurate and safe injection of steroid in trigger digits using ultrasound guidance. Acta Orthop Belg. 2006 Oct. 72 (5):633-4. [QxMD MEDLINE Link].

60. Lee DH, Han SB, Park JW, Lee SH, Kim KW, Jeong WK. Sonographically guided tendon sheath injections are more accurate than blind injections: implications for trigger finger treatment. J Ultrasound Med. 2011 Feb. 30 (2):197-203. [QxMD MEDLINE Link].

61. Jianmongkol S, Kosuwon W, Thammaroj T. Intra-tendon sheath injection for trigger finger: the randomized controlled trial. Hand Surg. 2007. 12 (2):79-82. [QxMD MEDLINE Link].

62. Sibbitt WL Jr, Michael AA, Poole JL, Chavez-Chiang NR, Delea SL, Bankhurst AD. Nerve blocks at the wrist for painful injections of the palm. J Clin Rheumatol. 2011 Jun. 17 (4):173-8. [QxMD MEDLINE Link].

63. Anderson B, Kaye S. Treatment of flexor tenosynovitis of the hand ('trigger finger') with corticosteroids. A prospective study of the response to local injection. Arch Intern Med. 1991 Jan. 151 (1):153-6. [QxMD MEDLINE Link].

64. Pataradool K, Buranapuntaruk T. Proximal phalanx injection for trigger finger: randomized controlled trial. Hand Surg. 2011. 16 (3):313-7. [QxMD MEDLINE Link].

65. Akhtar S, Bradley MJ, Quinton DN, Burke FD. Management and referral for trigger finger/thumb. BMJ. 2005 Jul 2. 331 (7507):30-3. [QxMD MEDLINE Link]. [Full Text].

66. Taras JS, Raphael JS, Pan WT, Movagharnia F, Sotereanos DG. Corticosteroid injections for trigger digits: is intrasheath injection necessary?. J Hand Surg Am. 1998 Jul. 23 (4):717-22. [QxMD MEDLINE Link].

67. Shinomiya R, Sunagawa T, Nakashima Y, Yoshizuka M, Adachi N. Impact of Corticosteroid Injection Site on the Treatment Success Rate of Trigger Finger: A Prospective Study Comparing Ultrasound-Guided True Intra-Sheath and True Extra-Sheath Injections. Ultrasound Med Biol. 2016 Sep. 42 (9):2203-8. [QxMD MEDLINE Link].

68. Colbourn J, Heath N, Manary S, Pacifico D. Effectiveness of splinting for the treatment of trigger finger. J Hand Ther. 2008 Oct-Dec. 21 (4):336-43. [QxMD MEDLINE Link].

69. Valdes K. A retrospective review to determine the long-term efficacy of orthotic devices for trigger finger. J Hand Ther. 2012 Jan-Mar. 25 (1):89-95; quiz 96. [QxMD MEDLINE Link].

70. Chao M, Wu S, Yan T. The effect of miniscalpel-needle versus steroid injection for trigger thumb release. J Hand Surg Eur Vol. 2009 Aug. 34 (4):522-5. [QxMD MEDLINE Link].

71. Lange-Riess D, Schuh R, Hönle W, Schuh A. Long-term results of surgical release of trigger finger and trigger thumb in adults. Arch Orthop Trauma Surg. 2009 Dec. 129 (12):1617-9. [QxMD MEDLINE Link].

72. Al-Qattan MM. Trigger fingers requiring simultaneous division of the A1 pulley and the proximal part of the A2 pulley. J Hand Surg Eur Vol. 2007 Oct. 32 (5):521-3. [QxMD MEDLINE Link].

73. Rojo-Manaute JM, Rodríguez-Maruri G, Capa-Grasa A, Chana-Rodríguez F, Soto Mdel V, Martín JV. Sonographically guided intrasheath percutaneous release of the first annular pulley for trigger digits, part 1: clinical efficacy and safety. J Ultrasound Med. 2012 Mar. 31 (3):417-24. [QxMD MEDLINE Link].

74. Hazani R, Whitney RD, Redstone J, Chowdhry S, Wilhelmi BJ. Safe treatment of trigger thumb with longitudinal anatomic landmarks. Eplasty. 2010 Sep 15. 10:[QxMD MEDLINE Link]. [Full Text].

75. Boretto J, Alfie V, Donndorff A, Gallucci G, DE Carli P. A prospective clinical study of the A1 pulley in trigger thumbs. J Hand Surg Eur Vol. 2008 Jun. 33 (3):260-5. [QxMD MEDLINE Link].

76. Gulabi D, Cecen GS, Bekler HI, Saglam F, Tanju N. A study of 60 patients with percutaneous trigger finger releases: clinical and ultrasonographic findings. J Hand Surg Eur Vol. 2014 Sep. 39 (7):699-703. [QxMD MEDLINE Link].

77. Migaud H, Fontaine C, Brazier J, Pierchon F, Duquennoy A. [Kapandji enlargement plasty of A1 pulley. Results in 15 primary trigger fingers with a 5 year (2-8 years) follow-up]. Ann Chir Main Memb Super. 1996. 15 (1):37-41; discussion 42. [QxMD MEDLINE Link].

78. Fitzgerald BT, Hofmeister EP, Fan RA, Thompson MA. Delayed flexor digitorum superficialis and profundus ruptures in a trigger finger after a steroid injection: a case report. J Hand Surg Am. 2005 May. 30 (3):479-82. [QxMD MEDLINE Link].

79. Peters-Veluthamaningal C, van der Windt DA, Winters JC, Meyboom-de Jong B. Corticosteroid injection for trigger finger in adults. Cochrane Database Syst Rev. 2009 Jan 21. CD005617. [QxMD MEDLINE Link].

Satishchandra Kale, MD, MBBS, MBA, MCh(Orth), FRCS(Edin), FRCS(Tr&Orth) Diploma in Sports and Exercise Medicine(UK)

Satishchandra Kale, MD, MBBS, MBA, MCh(Orth), FRCS(Edin), FRCS(Tr&Orth) is a member of the following medical societies: Bombay Orthopedic Society, British Orthopaedic Association, Royal College of Surgeons of Edinburgh

Disclosure: Nothing to disclose.

Harris Gellman, MD Consulting Surgeon, Broward Hand Center; Voluntary Clinical Professor of Orthopedic Surgery and Plastic Surgery, Departments of Orthopedic Surgery and Surgery, University of Miami, Leonard M Miller School of Medicine; Clinical Professor of Surgery, Nova Southeastern School of Medicine

Harris Gellman, MD is a member of the following medical societies: American Academy of Medical Acupuncture, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Society for Surgery of the Hand, Arkansas Medical Society, Florida Medical Association, Florida Orthopaedic Society

Disclosure: Nothing to disclose.

Michael T Andary, MD, MS Professor, Residency Program Director, Department of Physical Medicine and Rehabilitation, Michigan State University College of Osteopathic Medicine

Michael T Andary, MD, MS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Medical Association, and Association of Academic Physiatrists

Disclosure: Allergan Honoraria Speaking and teaching

P atrick M Foye, MD Associate Professor of Physical Medicine and Rehabilitation, Co-Director of Musculoskeletal Fellowship, Co-Director of Back Pain Clinic, Director of Coccyx Pain Service (Tailbone Pain Service: www.TailboneDoctor.com), University of Medicine and Dentistry of New Jersey, New Jersey Medical School

Patrick M Foye, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, Association of Academic Physiatrists, and International Spine Intervention Society

Disclosure: Nothing to disclose.

Joseph E Sheppard, MD Professor of Clinical Orthopedic Surgery, Chief of Hand and Upper Extremity Service, Department of Orthopedic Surgery, University of Arizona Health Sciences Center, University Physicians Healthcare

Joseph E Sheppard, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Society for Surgery of the Hand, and Orthopaedics Overseas

Disclosure: Nothing to disclose.

David R Steinberg, MD Director of Hand Fellowship, Associate Professor, Department of Orthopedic Surgery, University of Pennsylvania Health System

David R Steinberg, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons and American Society for Surgery of the Hand

Disclosure: Johnson & Johnson nothing received, but have long-term ownership of public equities none

Todd P Stitik, MD Professor, Department of Physical Medicine and Rehabilitation, Director, Outpatient Occupational/Musculoskeletal Medicine, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Todd P Stitik, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists, Phi Beta Kappa, and Physiatric Association of Spine, Sports and Occupational Rehabilitation

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Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Robert E Windsor, MD, FAAPMR, FAAEM, FAAPM President and Director, Georgia Pain Physicians, PC; Clinical Associate Professor, Department of Physical Medicine and Rehabilitation, Emory University School of Medicine

Robert E Windsor, MD, FAAPMR, FAAEM, FAAPM is a member of the following medical societies: American Academy of Pain Medicine, American Academy of Physical Medicine and Rehabilitation, American College of Sports Medicine, American Medical Association, International Association for the Study of Pain, and Texas Medical Association

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Acknowledgments

The authors and editors of Medscape Reference would like to thank medical students Dena Abdelshahed and Leia Rispoli, plus Drs. Debra Ibrahim, Evish Kamrava, Jason Lee, Cyrus Kao, and Dev Sinha, for their help in previous revisions of a source article.

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