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This is a summary of the Northern, Eastern & Western Devon CCG and South Devon and Torbay CCG commissioning policy for Trigger finger release in adults. (Live from 31 March 2019)
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.
a) one or two steroid injections which are typically successful, but the problem may recur, especially in patients with diabetes
b) splinting of the affected finger for 3-12 weeks
a) the triggering persists or recurs after one of the above measures (particularly steroid injections)
b) the finger is permanently locked in the palm
c) the patient has previously had 2 other trigger digits unsuccessfully treated with appropriate non-operative methods
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).
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 the CCG upon receipt of a completed application from the patient's GP, consultant or clinician. Applications cannot be considered from patients personally.
Queries and applications should be submitted by clinicians to the Individual Funding Request Panel via our generic email address:
Applications should be submitted by clinicians to the Individual Funding Request Panel via the CCG generic email address:
Date of publication: 8 March 2019