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Stenosing Flexor Tenosynovitis (Trigger Finger)

Stenosing tenosynovitis, the flexor tendon may become trapped at the entrance to its fibrous digital sheath.

The usual cause is thickening of fibrous tendon sheath or constriction of mouth of fibrous digital sheath. (mainly Al pulley) at the level of metacarpophalangeal joint.

  1. Causes
    1. Local trauma
    2. Unaccustomed activity
    3. Rheumatoid arthritis (RA)
    4. Diabetes Mellitus
    5. Gout
  2. Clinical Feature Treatment
    Although any digit (including the thumb) may be affected, but the ring and middle fingers are most commonly involved.

Patient frequently notes catching / locking / triggering of affected finger after forceful flexion. In some instances the opposite hand must be used to passively bring the finger into extension.

Description: trigger      Description: download (20)

Description: si55550723_96472_1

  1. Treatment
    1. Injection of methyl prednisolone into the tendon sheath.
    2. Surgical release of A1 pulley. A2 pulley must be spared to preserve effective digital flexion.

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