The management of trigger digit is controversial. Up to a third of cases may resolve spontaneously if treated with splintage and passive stretching; these cases generally are the ones that are not fixed in position at presentation. For all other cases, surgery is indicated.
Surgical treatment of congenital trigger finger entails release of the A1 pulley under general anaesthetic. The skin incision is made at the level of the MCPJ flexion crease. Digital nerves and vessels are protected and the A1 pulley is exposed and divided. There is no loss in range of motion.
Recovery tends to be complete where a discrete constriction of the tendon is the cause but if the digit does not glide immediately, consider alternative anatomical causes such as anomalous connections or constrictions between the flexor tendons to the digits.
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