Trigger finger is a condition in which the tendons of the finger or thumb catch or lock, causing pain and stiffness.
Types
There are two types of trigger finger:
Primary trigger finger: It is the most common type and occurs without any underlying medical condition.
Secondary trigger finger: It occurs due to an underlying medical condition such as rheumatoid arthritis, gout, or diabetes.
Pathology
The pathology of trigger finger involves the tendon sheath, which is a synovial sheath that surrounds the tendon.
The tendon sheath becomes inflamed and thickened, causing the tendon to catch or lock.
Causes
The causes of trigger finger include:
Repetitive motion or overuse of the hand or fingers
Injury or trauma to the hand or fingers
Medical conditions such as rheumatoid arthritis, gout, or diabetes
Congenital conditions such as Dupuytren's contracture
Clinical Features
The clinical features of trigger finger include:
Pain and stiffness in the affected finger or thumb
Clicking or snapping sensation when bending or straightening the finger or thumb
Locking or catching of the tendon
Swelling and redness in the affected area
Investigations
The investigations for trigger finger include:
Physical examination
X-rays to rule out underlying bone or joint problems
Ultrasound or MRI to evaluate the tendon sheath and surrounding tissues
Complications
The complications of trigger finger include:
Chronic pain and stiffness
Limited range of motion
Decreased grip strength
Tendon rupture
Management
The management of trigger finger includes:
Conservative treatment such as rest, ice, compression, and elevation
Physical therapy to improve range of motion and strength
Steroid injections to reduce inflammation
Surgery to release the tendon sheath and repair any damaged tissue
Treatment
The treatment for trigger finger includes:
Trigger finger release surgery
Tendon repair surgery
Tenosynovectomy (removal of the tendon sheath)
Blood Supply
The blood supply to the hand and fingers is provided by the radial and ulnar arteries.
The radial artery supplies the thumb, index finger, and middle finger.
The ulnar artery supplies the ring finger and little finger.
Nerve Supply
The nerve supply to the hand and fingers is provided by the median and ulnar nerves.
The median nerve supplies the thumb, index finger, middle finger, and half of the ring finger.
The ulnar nerve supplies the remaining half of the ring finger and the little finger.
Clinical Anatomy
The clinical anatomy of the hand and fingers includes:
The skeletal system, which consists of bones, joints, and ligaments.
The muscular system, which consists of muscles, tendons, and ligaments.
The nervous system, which consists of nerves and ganglia.
The vascular system, which consists of arteries, veins, and capillaries.
Homoeopathic Therapeutic Medicines
The following homoeopathic medicines are used to treat trigger finger:
Arnica montana: For pain and inflammation
Hypericum perforatum: For nerve pain and inflammation
Rhus toxicodendron: For stiffness and limited range of motion
Calcarea carbonica: For chronic pain and stiffness
Indications
The indications for homoeopathic treatment include:
Acute pain and inflammation
Chronic pain and stiffness
Limited range of motion
Decreased grip strength
Operative Method
The operative method for trigger finger release surgery includes:
Step 1 → Incision of the skin and soft tissues
Step 2 → Identification and release of the tendon sheath
Step 3 → Repair of any damaged tissue
Step 4 → Closure of the skin and soft tissues
Operative Step-by-Step Sequence
The operative step-by-step sequence for trigger finger release surgery includes:
→ Step 1: Incision of the skin and soft tissues
→ Step 2: Identification and release of the tendon sheath
→ Step 3: Repair of any damaged tissue
→ Step 4: Closure of the skin and soft tissues