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Trigger digits: diagnosis and treatment.

M J Saldana1

  • 1Hand and Microsurgery Associates, Nix Medical Center, Suite 809, 44 Navarro, San Antonio, TX 78229, USA.

The Journal of the American Academy of Orthopaedic Surgeons
|July 31, 2001
PubMed
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Stenosing tenosynovitis, or triggering digits, affects the thumb and fingers. Most cases (85%) resolve with non-surgical treatments like corticosteroid injections, while surgery is reserved for persistent cases.

Area of Science:

  • Orthopaedics
  • Hand Surgery
  • Rheumatology

Background:

  • Stenosing tenosynovitis, commonly known as triggering digits, is a frequent condition affecting the thumb and fingers.
  • It can be primary (idiopathic) or secondary to connective tissue disorders like rheumatoid arthritis, diabetes, or gout.
  • The condition is prevalent in middle-aged women but can occur at any age.

Purpose of the Study:

  • To review the diagnosis, classification, and treatment of stenosing tenosynovitis of the digits.
  • To highlight the efficacy of nonoperative and operative management strategies.
  • To discuss the prognostic significance of classification and symptom duration.

Main Methods:

  • Clinical examination is the primary diagnostic tool for triggering digits.

Related Experiment Videos

  • Classification based on tenosynovitis type and symptom duration aids in prognosis and treatment planning.
  • Review of treatment outcomes for nonoperative and surgical interventions.

    • Main Results:

    • Up to 85% of triggering fingers and thumbs can be successfully treated nonoperatively.
    • Corticosteroid injections and nonsteroidal anti-inflammatory drugs are effective primary treatments.
    • Surgical release is indicated for cases unresponsive to nonoperative management.

    Conclusions:

    • Triggering digits is a common condition with a generally favorable prognosis.
    • Nonoperative management, including corticosteroid injections, is highly effective for most patients.
    • Percutaneous A1 pulley release offers a safe and effective office-based surgical option when conservative measures fail.