Trigger finger release in adults

Referral Criteria

Trigger finger often resolves over time and is often a nuisance rather than a serious problem. If treatment is necessary steroid injection can be considered. Surgery should only be offered in specific cases according to National Institute for Health and Care Excellence (NICE) accredited guidelines by the British Society for Surgery to the Hand, where alternative measures have not been successful and persistent or recurrent triggering, or a locked finger occurs.

Mild cases which cause no loss of function require no treatment or avoidance of activities which precipitate triggering and may resolve spontaneously.

Cases interfering with activities or causing pain should first be treated with:

a) one or two steroid injections

Or

b) splinting of the affected finger for 3 -12 weeks

Surgery should be considered if:

a) the triggering persists or recurs after one of the above measures (particularly steroid injections)

Or

b) the finger is permanently locked in the palm

Or

c) the patient has previously had 2 other trigger digits unsuccessfully treated with appropriate non-operative methods

Or

d) the patient has diabetes

Surgery is usually effective and requires a small skin incision in the palm, but can be done with a needle through a puncture wound (percutaneous release).

Commissioning policy: Trigger finger release in adults

Where the circumstances of treatment for an individual patient do not meet the criteria described above exceptional funding can be sought. Individual cases will be reviewed by the appropriate panel of NHS Devon upon receipt of a completed application from the patient's GP, consultant or clinician. Applications cannot be considered from patients personally.

Referral Instructions

Queries and applications should be submitted by clinicians to the Individual Funding Request Panel via our generic email address: d-icb.ifr-newsdt@nhs.net

Exceptional /Individual Funding Requests (IFR)

Referral Forms

Referral Form – Individual Funding Request (IFR)

Patient Information

Individual Funding Request (IFR)

Date of publication: 31 March 2019