The Snapping Fingers Mystery

Author

Jesse Dashe MD
February 20, 2024

Topic: Trigger Fingers

Greetings colleagues,

Welcome to the Hands-On The East Bay Newsletter, which summarizes key topics in hand surgery for providers on the front lines. I'm Dr. Jesse Dashe, an orthopedic hand surgeon at the East Bay Hand Medical Center.

What is Stenosing Tenosynovitis?

Stenosing Tenosynovitis, commonly referred to as Trigger Finger, is a condition where there is a localized stenosis or constriction of the tendon sheath at the level of the first annular (A1) pulley leading to difficulty in finger flexion and extension, often with a catching or locking phenomenon.

What are common causes?

-Prolonged, forceful, or repetitive finger movements

-Rheumatoid arthritis

-Diabetes mellitus

-Gout

Typical symptoms?

-Catching or snapping sensation in the affected finger

-Pain on finger flexion and extension

-Tender nodule may be palpable

-Morning stiffness or contracture in severe cases

What workup is needed?

-Clinical examination usually suffices

-Ultrasound can help verify the diagnosis

What is the first line treatment?

-Non-steroidal, anti-inflammatory medication (NSAIDs)

-Splinting 

-Corticosteroid injection near the A1 pulley

-Surgical release may be needed if non-operative measures fail

Please feel free to reach out if you have any questions or would like to refer any patients. You can refer patients at handreferral.com or by using this link:

If you need to reach me directly, please respond to this email or email me at [email protected].

Please contact me so I can come by your facility to meet face-to-face and/or give presentations, splinting sessions, etc.

Lastly, let me know if you have any other hand topics you would like covered in the future!

Sincerely,