A finger-catching or locking sensation is the most indicative symptom of stenosing tenosynovitis, which is known by the elucidatory name of "trigger finger" (TF) in English bibliography. The cause of this quite common and painful condition lies in the tendon sheath, the tunnel through which the flexor tendon run, which gets inflamed when irritation occurs. This means that the space in the sheath decreases. As a result, the tendon becomes subject to friction and gets swollen, since it cannot glide smoothly into the sheath.

This condition causes a painful "bounce" of the tendon whenever it tries to transfer movement. The finger may become completely stiff or difficult to flex, especially in the early morning hours. Pain, to varying degrees, focused at the base of the finger and exacerbated when pressure is applied to the point is a major complaint of patients. Sometimes, when the tendon is released from the pressure exerted by the narrow sheath, the patients describe a feeling of dislocation. In cases that have long been untreated, the finger cannot extend, not even with help.

More commonly affected is the thumb, followed by the index and the median, and occasionally the small finger of the hand - the condition occurs more often in the so-called dominant hand and may involve more than one finger.

TF most commonly occurs between women from 40 to 60 years of age, diabetics, also in patients with rheumatoid arthritis, gout, or thyroid problems or even those performing repetitive gripping movements. Often, it exists in conjunction with other maladies, such as carpal tunnel syndrome, de Quervain tendonitis, epicondylitis or subacromial bursitis.

The ailment is categorized according to the degree of pain and sensitivity, the degree of "clicking’’ and flexing of the finger. In the initial stages, the trigger finger is conservatively treated by a change in activities that burden the inflammation, application  of a splint, medication, and localized steroid injection into the flexor sheath.

However, in cases where the symptoms affect the quality of life of the patient, and in cases where the finger remains permanently in a flexed position, a percutaneous release is required, which is done with local anesthesia and has excellent results. The doctor's goal is to grow the space inside the sheath so that the tendon can move more easily.

For surgery, local anesthesia is required, done through a minimal incision, and the patient returns to his home the very same day. Given that the opening of the sheath has no effect on the functionality of the fingers, their movement is free from the first day. Post-operative attention is required for 48 hours. Sutures are removed in about 10 days.

It is worth noting that there is also the congenital pediatric trigger thumb that affects infants and it is noticed when they start to use their hands. The incidence is from 0.05-2%, for both sexes, and 25% in both hands at the same time. It is assumed that it is not a real congenital problem but occurs in the first few weeks of life.

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