Trigger finger (TF) is a prevalent hand condition characterized by impaired tendon gliding and pulley thickening, leading to pain and functional limitations. This narrative review explores TF's functional assessment, sonographic findings, and conservative treatments. Tools like the Quinnell Grading System and Jamar Dynamometer effectively quantify severity and function, while ultrasound identifies hypoechoic A1 pulley thickening (> 0.62 mm) and tendon snapping. Conservative treatments, including splinting and tendon gliding exercises, reduce pain by 70% within weeks. Ultrasound-guided corticosteroid injections and percutaneous A1 pulley release improve outcomes with minimal complications. Integrating imaging and personalized therapies optimizes TF management, reducing surgical reliance.

Clinical and Experimental Medicine PhD Program University of Modena and Reggio Emilia Modena Italy

Department of Orthopedic and Traumatological Surgery IRCCS Istituto Ortopedico Rizzoli University of Bologna Bologna Italy

Hand Rehabilitation Unit Policlinico di Modena Modena Italy

Independent Researcher Bologna Italy

Institute of Anatomy 1st Faculty of Medicine Charles University Prague Czech Republic

Orthopaedics and Trauma Unit University of Modena and Reggio Emilia Modena Italy

Physical and Rehabilitation Medicine Unit Luigi Sacco University Hospital ASST Fatebenefratelli Sacco Milan Italy

Physical Therapy and Rehabilitation Unit IRCCS Istituto Ortopedico Rizzoli University of Bologna Bologna Italy

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M. R and J. W, “Trigger Digits: Principles, Management, and Complications,” Journal of Hand Surgery 31, no. 1 (2006): 135–146, https://doi.org/10.1016/j.jhsa.2005.10.013.

G. T. Lin, P. C. Amadio, K. N. An, and W. P. Cooney, “Functional Anatomy of the Human Digital Flexor Pulley System,” Journal of Hand Surgery 14, no. 6 (1989): 949–956, https://doi.org/10.1016/s0363‐5023(89)80043‐7.

A. H. Makkouk, M. E. Oetgen, C. R. Swigart, and S. D. Dodds, “Trigger Finger: Etiology, Evaluation, and Treatment,” Current Reviews in Musculoskeletal Medicine 1, no. 2 (2008): 92–96, https://doi.org/10.1007/s12178‐007‐9012‐1.

J. S. Moore, “Flexor Tendon Entrapment of the Digits (Trigger Finger and Trigger Thumb),” Journal of Occupational and Environmental Medicine 42, no. 5 (2000): 526–545, https://doi.org/10.1097/00043764‐200005000‐00012.

A. C. Lundin, P. Aspenberg, and P. Eliasson, “Trigger Finger, Tendinosis, and Intratendinous Gene Expression,” Scandinavian Journal of Medicine & Science in Sports 24, no. 2 (2014): 363–368, https://doi.org/10.1111/j.1600‐0838.2012.01514.x.

J. T. Hueston and W. F. Wilson, “The Aetiology of Trigger Finger Explained on the Basis of Intratendinous Architecture,” Hand 4, no. 3 (1972): 257–260, https://doi.org/10.1016/s0072‐968x(72)80010‐x.

N. Ochiai, T. Matsui, N. Miyaji, R. J. Merklin, and J. M. Hunter, “Vascular Anatomy of Flexor Tendons. I. Vincular System and Blood Supply of the Profundus Tendon in the Digital Sheath,” Journal of Hand Surgery 4, no. 4 (1979): 321–330, https://doi.org/10.1016/s0363‐5023(79)80068‐4.

K. Drossos, M. Remmelink, N. Nagy, V. de Maertelaer, J. L. Pasteels, and F. Schuind, “Correlations Between Clinical Presentations of Adult Trigger Digits and Histologic Aspects of the A1 Pulley,” Journal of Hand Surgery 34, no. 8 (2009): 1429–1435, https://doi.org/10.1016/j.jhsa.2009.05.015.

F. D. Ellis, J. G. Seiler, and C. W. Sewell, “The Second Annular Pulley: A Histologic Examination,” Journal of Hand Surgery 20, no. 4 (1995): 632–635, https://doi.org/10.1016/s0363‐5023(05)80281‐3.

B. M. Katzman, D. M. Klein, T. C. Garven, D. A. Caligiuri, J. Kung, and E. D. Collins, “Anatomy and Histology of the A5 Pulley,” Journal of Hand Surgery 23, no. 4 (1998): 653–657, https://doi.org/10.1016/S0363‐5023(98)80051‐8.

V. Ricci, K. V. Chang, O. Güvener, et al., “EURO‐MUSCULUS/USPRM Dynamic Ultrasound Protocols for Shoulder,” American Journal of Physical Medicine & Rehabilitation 101, no. 3 (2022): e29–e36, https://doi.org/10.1097/PHM.0000000000001833.

A. J. Abdulsalam, K. Mezian, V. Ricci, and L. Özçakar, “Injecting the Trigger Finger: Target (With Ultrasound), Then Shoot!,” Journal of Primary Care and Community Health 12 (2021): 21501327211000237, https://doi.org/10.1177/21501327211000237.

A. J. Abdulsalam, K. Mezian, V. Ricci, et al., “Interdigital Approach to Trigger Finger Injection Using Ultrasound Guidance,” Pain Medicine 20, no. 12 (2019): 2607–2610, https://doi.org/10.1093/pm/pnz109.

L. Fuchs, N. Gafni, T. Brosh, S. Saleh, Y. Kosashvili, and A. Oron, “Ulnar Superficialis Slip Resection Versus Radial Superficialis Slip Resection: A Biomechanical Pilot Study,” Hand (N Y) 18, no. 4 (2023): 624–627, https://doi.org/10.1177/15589447211060416.

S. Bianchi, S. Gitto, and F. Draghi, “Ultrasound Features of Trigger Finger: Review of the Literature,” Journal of Ultrasound in Medicine 38, no. 12 (2019): 3141–3154, https://doi.org/10.1002/jum.15025.

A. Spirig, B. Juon, Y. Banz, R. Rieben, and E. Vögelin, “Correlation Between Sonographic and In Vivo Measurement of A1 Pulleys in Trigger Fingers,” Ultrasound in Medicine & Biology 42, no. 7 (2016): 1482–1490, https://doi.org/10.1016/j.ultrasmedbio.2016.02.017.

H. Gruber, S. Peer, and A. Loizides, “The “Dark Tendon Sign” (DTS): A Sonographic Indicator for Idiopathic Trigger Finger,” Ultrasound in Medicine & Biology 37, no. 5 (2011): 688–692, https://doi.org/10.1016/j.ultrasmedbio.2011.01.019.

B. Ten, Z. M. Asfuroğlu, M. M. Eskandari, et al., “The Place of B‐Mode Ultrasonography, Shear‐Wave Elastography, and Superb Microvascular Imaging in the Diagnosis of de Quervain Tenosynovitis,” Journal of Clinical Ultrasound 52, no. 5 (2024): 499–510, https://doi.org/10.1002/jcu.23661.

L. Leong, S. C. Chai, J. W. Howell, and M. J. Hirth, “Orthotic Intervention Options to Non‐Surgically Manage Adult and Pediatric Trigger Finger: A Systematic Review,” Journal of Hand Therapy 36, no. 2 (2023): 302–315, https://doi.org/10.1016/j.jht.2023.05.016.

D. Lunsford, K. Valdes, and S. Hengy, “Conservative Management of Trigger Finger: A Systematic Review,” Journal of Hand Therapy 32, no. 2 (2019): 212–221, https://doi.org/10.1016/j.jht.2017.10.016.

A. S. Tenforde, H. E. Borgstrom, S. DeLuca, et al., “Best Practices for Extracorporeal Shockwave Therapy in Musculoskeletal Medicine: Clinical Application and Training Consideration,” PM & R: The Journal of Injury, Function, and Rehabilitation 14, no. 5 (2022): 611–619, https://doi.org/10.1002/pmrj.12790.

P. Yildirim and O. H. Gunduz, “What Is the Role of Semmes‐Weinstein Monofilament Testing in the Diagnosis of Electrophysiologically Graded Carpal Tunnel Syndrome?,” Journal of Physical Therapy Science 27, no. 12 (2015): 3749–3753, https://doi.org/10.1589/jpts.27.3749.

A. C. Sahoo, S. Soumyashree, and C. Mahapatra, “The Role of Physiotherapy in the Treatment of Chronic Trigger Finger—A Case Report,” Bulletin of Faculty of Physical Therapy 28, no. 1 (2023): 27, https://doi.org/10.1186/s43161‐023‐00137‐8.

C. Gyuricza, E. Umoh, and S. W. Wolfe, “Multiple Pulley Rupture Following Corticosteroid Injection for Trigger Digit: Case Report,” Journal of Hand Surgery 34, no. 8 (2009): 1444–1448, https://doi.org/10.1016/j.jhsa.2009.04.037.

P. Boccolari, F. Pantaleoni, D. Donati, and R. Tedeschi, “Non‐Surgical Treatment of Oblique Diaphyseal Fractures of the Fourth and Fifth Metacarpals in a Professional Athlete: A Case Report,” International Journal of Surgery Case Reports 115 (2024): 109256, https://doi.org/10.1016/j.ijscr.2024.109256.

E. Lanfranchi, S. Vandelli, P. Boccolari, D. Donati, D. Platano, and R. Tedeschi, “Efficacy and Patient Acceptability of 3 Orthosis Models for Radial Nerve Palsy,” Hand Surgery and Rehabilitation 43, no. 2 (2024): 101677, https://doi.org/10.1016/j.hansur.2024.101677.

R. Rohilla, H. Kaur, and P. Tiwari, “Comparison of Efficacy and Safety of USG‐Guided Versus Blind Pulley Release for Trigger Finger: A Systematic Review and Meta‐Analysis,” Journal of Clinical Orthopaedics and Trauma 58 (2024): 102795, https://doi.org/10.1016/j.jcot.2024.102795.

P. E. Ferrara, S. Codazza, S. Cerulli, G. Maccauro, G. Ferriero, and G. Ronconi, “Physical Modalities for the Conservative Treatment of Wrist and Hand's Tenosynovitis: A Systematic Review,” Seminars in Arthritis and Rheumatism 50, no. 6 (2020): 1280–1290, https://doi.org/10.1016/j.semarthrit.2020.08.006.

P. E. Ferrara, S. Codazza, G. Maccauro, G. Zirio, G. Ferriero, and G. Ronconi, “Physical Therapies for the Conservative Treatment of the Trigger Finger: A Narrative Review,” Orthopedic Reviews 12, no. 1 (2020): 8680, https://doi.org/10.4081/or.2020.8680.

P. Yildirim, A. Gultekin, A. Yildirim, A. Y. Karahan, and F. Tok, “Extracorporeal Shock Wave Therapy Versus Corticosteroid Injection in the Treatment of Trigger Finger: A Randomized Controlled Study,” Journal of Hand Surgery, European Volume 41, no. 9 (2016): 977–983, https://doi.org/10.1177/1753193415622733.