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World J Orthop. Oct 18, 2023; 14(10): 733-740
Published online Oct 18, 2023. doi: 10.5312/wjo.v14.i10.733
Triggering, clicking, locking and crepitus of the finger: A comprehensive overview
Pieter W Jordaan, Raymond Klumpp, Marco Zeppieri
Pieter W Jordaan, Department of Orthopaedic, Garden Route Hand Unit, George 6530, South Africa
Raymond Klumpp, UOC Ortopedia e Traumatologia, Ospedale Treviglio-Caravaggio ASST, Bergamo Ovest 24047, Italy
Marco Zeppieri, Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
Author contributions: Jordan PW, Klumpp R, and Zeppieri M contributed equally to this work; All authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marco Zeppieri, BSc, MD, PhD, Doctor, Department of Ophthalmology, University Hospital of Udine, p.le S. Maria della Misericordia 15, Udine 33100, Italy. markzeppieri@hotmail.com
Received: August 21, 2023
Peer-review started: August 21, 2023
First decision: September 13, 2023
Revised: September 13, 2023
Accepted: October 8, 2023
Article in press: October 8, 2023
Published online: October 18, 2023
Processing time: 56 Days and 1.3 Hours
Abstract

Triggering, locking, clicking, and crepitus of the fingers are common symptoms patients present with. Even though crepitus and triggering can occur as part of the same underlying diagnosis, it is important to differentiate between them, as they usually indicate different possible diagnoses. The differential diagnoses that should be considered include trigger finger, metacarpophalangeal joint (MCPJ) arthritis, fractures or dislocations, extensor digitorum communis subluxation or dislocation, locked MCPJ, avascular necrosis of the metacarpal head, and Dupuytren’s disease. A thorough clinical examination with appropriate special investigations can permit the clinician to make the correct diagnosis. Appropriate management of a confirmed diagnosis is successful in providing symptomatic improvement.

Keywords: Trigger finger; Locking; Crepitus; Metacarpophalangeal joint; Dislocation; Differential diagnosis

Core Tip: Despite trigger fingers being one of the most common causes of hand pain and disability, there are other possible causes of triggering, locking, clicking, and crepitus of the fingers. Failure to recognize and diagnose these other causes can lead to treatment errors and inappropriate management of patients.