Diagnosis and treatment of trigger digits: an updated review

The condition usually presents with triggering during finger flexion and extension, as well as tenderness at the A1 pulley region, at the level of the metacarpus. The goal of treatment is to restore an undisturbed full range of motion in the affected digit. The most common treatments include steroid injection and surgical release of the A1 pulley, either open or percutaneous. The article presents various management options and their effectiveness. Steroid injections are effective in 70–80% of cases (providing pain relief and resolution of triggering), but recurrence occurs in as many as half of the patients within 6 months. Open surgical release achieves recovery in up to 97% of patients, with rare relapses, but it may be associated with complications such as finger stiffness, painful scarring, algodystrophy, or digital nerve injury. Percutaneous release is considered less traumatic and, therefore, associated with minimal morbidity. Minimally invasive therapy is undoubtedly more cost-effective, can be performed on an outpatient basis, and allows for faster functional recovery. The article also presents the results of studies evaluating which treatment strategy is the most economically justified.