Trigger finger
Dual Syringe Injector Manual (PDF)
Thickening of a finger flexor tendon combined with narrowing of the tendon sheath may produce locking of the finger. The finger locks in a flexed position and may be extended with a click (trigger sign). Injecting steroid into the tendon sheath will eliminate oedema and inflammation and the triggering disappears. It is most important not to inject the steroid into the tendon itself, which might produce a tendon rupture.
Trigger finger technique
The tendon sheath of the locking finger is reached proximal to the first annular ligament at the distal flexion crease. Introduce the needle through the skin tangential to the tendon sheath. Inject local anesthesia with the Dual Injector while penetrating the skin, advance the needle deep into tendon and check that the needle moves with the tendon when moving the finger. Retract the needle until it no longer moves with the tendon. With this technique a correct placement of the needle tip is guaranteed inside the tendon sheath, but not inside the tendon. Inject 0,25 cc of Lederspan®. Inject anesthesia when retracting the needle. Put adhesive tape over the needle spot.
The tendon sheath of the locking finger is reached proximal to the first annular ligament at the distal flexion crease. Introduce the needle through the skin tangential to the tendon sheath. Inject local anesthesia with the Dual Injector while penetrating the skin, advance the needle deep into tendon and check that the needle moves with the tendon when moving the finger. Retract the needle until it no longer moves with the tendon. With this technique a correct placement of the needle tip is guaranteed inside the tendon sheath, but not inside the tendon. Inject 0,25 cc of Lederspan®. Inject anesthesia when retracting the needle. Put adhesive tape over the needle spot.
Trigger thumb technique
Triggering of the thumb is as common as trigger finger and can be treated in the same way. The needle is introduced through the skin of the MCP joint flexion crease of the thumb. Use the same technique as described above.
Triggering of the thumb is as common as trigger finger and can be treated in the same way. The needle is introduced through the skin of the MCP joint flexion crease of the thumb. Use the same technique as described above.
This technique can also be used when injecting tenosynovitis in the flexor tendon sheath, e.g. in rheumatoid arthritis.
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