Clinical Review of Trigger Finger in Pediatric and Adult Patients: Evaluation and Management Strategies.

Trigger finger (TF), also known as stenosing tenosynovitis, is a condition characterized by pain, locking, and restricted motion of the digits due to narrowing and inflammation of the flexor tendon sheath, most commonly at the A1 pulley. This review examines both adult and pediatric TF (PTF), emphasizing pathophysiology, diagnosis, and evidence-based treatment strategies. In adults, TF is strongly associated with repetitive finger movements, diabetes mellitus, and inflammatory arthritides. Conservative treatments such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, splinting, and extracorporeal shock wave therapy are available, though effectiveness varies with disease severity and comorbidities. Corticosteroid injections achieve symptom resolution in 70%-90% of non-diabetic patients, though recurrence rates rise with repeated injections. Surgical options (open, percutaneous, ultrasound-guided, and endoscopic) generally exceed 90% success rates with low recurrence. In pediatric patients, TF is uncommon and often linked to systemic or syndromic conditions. Observation and splinting may be effective in 30%-60% of cases, while surgical A1 pulley release provides resolution in 80%-90%, particularly in severe or multi-digit cases. This review highlights novel treatment algorithms for adult TF and PTF and emphasizes the importance of patient-specific management. A detailed understanding of these distinctions is crucial for optimizing outcomes.