What is the prognosis of trigger finger (TF)?

Updated: Apr 26, 2021
  • Author: Satishchandra Kale, MD, MBBS, MBA, MCh(Orth), FRCS(Edin), FRCS(Tr&Orth); Chief Editor: Harris Gellman, MD  more...
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Answer

The prognosis in TF is very good; most patients respond to corticosteroid injection with or without associated splinting. Some cases of TF may resolve spontaneously and then reoccur without obvious correlation with treatment or exacerbating factors.

Freiberg et al found a greater success rate for TF injection therapy when the treatment was used in patients in whom an examiner could palpate a discrete, rather than a diffuse, nodular consistency in the flexor sheath. [24] Digits with a discrete, palpable nodule had a 93% success rate with a single injection of triamcinolone at 3 months' follow-up, whereas digits with a diffuse pattern had a 52% failure rate.

Marks and Gunther reported an 84% success rate in trigger digits and a 92% success rate in trigger thumbs following a single injection of triamcinolone. [14]

Using sonoelastography, a newer technique for quantitative assessment of the stiffness of soft tissues, one group noted that the causes for snapping in trigger finger were increased stiffness and thickening of the A1 pulley. Three weeks after corticosteroid injection, the pulley thickness and the ratio of subcutaneous fat to the pulley both decreased; snapping disappeared in all patients studied. [18]

Griggs and co-investigators reported an overall success rate of 50% for steroid injection in patients with DM. [25] Patients with insulin-dependent diabetes had a higher incidence of multiple digit involvement and required surgical release more frequently than did patients who were not insulin dependent. [26, 27]


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