A New Test for Trigger Finger: The Lenox Independent Flexion Test

Background: The diagnosis of trigger finger (TF) in patients who do not demonstrate triggering at presentation can be challenging. We have been using a new test for TF - the Lenox Independent Flexion Test (LIFT). The aim of this study is to determine the sensitivity of LIFT in diagnosing TF. We hypothesise that LIFT will be more sensitive compared to the classic physical exam finding of triggering or locking with active range of motion (AROM). Methods: This is a prospective study of consecutive patients with TF over a 5-month period. Patients with the onset of trigger following trauma and trigger of the thumb were excluded. Patients were examined for tenderness over the first annular (A1) pulley, triggering or locking with AROM, and the LIFT was performed. A two-proportion test was used to determine whether the LIFT was more sensitive than triggering with AROM. Results: The study included 85 patients with 118 TFs. The average age of patients was 63 years and the study included 49 women. There were 69, 49, 0 and 0 grade I, II, III and IV TF, respectively. 108 fingers (92%) had a history of catching or locking of the affected digit, 110 (93%) had tenderness over the A1 pulley, 49 (44%) had triggering or locking with AROM and 102 (91%) had a positive LIFT. The LIFT was found to be more sensitive when compared to triggering with AROM (p < .001). Conclusion: The LIFT is more sensitive than triggering with AROM in the diagnosis of trigger digits. This test is especially useful in the diagnosis of TF in patients who do not have triggering at presentation. Level of Evidence: Level III (Diagnostic).