28/03/2026
Trigger finger.
A painful condition where the flexor tendon gets trapped under the A1 pulley of the finger. It is more common for the 2-4th finger to get this for those that do predominantly finger based movements like computers, tailors, even bakers that knead a lot.. sometimes we see it at the thumb too. It commonly affects the flexor digitorum profundus tendon.
It is more commonly seen in diabetics too.
Green classification
Grade I: Palm pain and tenderness at A-1 pulley
Grade II: Catching of digit, can be actively released
Grade III: Locking of digit, passively correctable
Grade IV: Fixed, locked digit
So for grade 1, activity modification, occupational therapy helps the conditions
For grade 2, may need a cortisone injection with physical therapy and activity modification
Grade 3, trial of cortisone can be done with physical therapy and activity modification. If fails, operation needed.
Grade 4: likely operative method
Be aware of this, treat it early. Avoid unnecessary complication.
Here, I'm doing a ultrasound guided injection using in plane method. As the cortisone is injected, you can see the tendon sheath distending.