Trigger finger
Meaning of trigger finger: For the purposes of this Statement of Principles, trigger finger, also known as stenosing flexor tenosynovitis, means a tendon entrapment of one or more digits, where enlargement of the tendon or narrowing of its flexor pulley sheath leads to the tendon being unable to slide smoothly within the sheath.
Reasonable Hypothesis (RH) — Statement of Principles No. 39 of 2019
At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting trigger finger or death from trigger finger with the circumstances of a person's relevant service:
- (1)performing repetitive activities or forceful activities using the affected hand, for a cumulative period of at least 500 hours within the six months before the clinical onset of trigger finger;
Note: forceful activities and repetitive activities are defined in the Schedule 1 - Dictionary.
- (2)having acute trauma involving the affected tendon or tendon sheath, within the one year before the clinical onset of trigger finger;
Note: Examples of acute trauma include, but are not limited to, a laceration, puncture, heavy blow, fracture and crush injury.
- (3)having carpal tunnel release involving the wrist on the affected side, within the one year before the clinical onset of trigger finger;
- (4)having diabetes mellitus before the clinical onset of trigger finger;
- (5)having a space occupying lesion involving the affected tendon or tendon sheath at the time of the clinical onset of trigger finger;
Note: Examples of a space occupying lesion include, but are not limited to, amyloid deposit, gouty tophus, granuloma and post-surgery adhesion.
- (6)being treated with an aromatase inhibitor within the one year before the clinical onset of trigger finger;
Note: Examples of aromatase inhibitors include, but are not limited to, anastrozole, exemestane and letrozole.
- (7)performing repetitive activities or forceful activities using the affected hand, for a cumulative period of at least 500 hours within the six months before the clinical worsening of trigger finger;
Note: forceful activities and repetitive activities are defined in the Schedule 1 - Dictionary.
- (8)having acute trauma involving the affected tendon or tendon sheath, within the one year before the clinical worsening of trigger finger;
Note: Examples of acute trauma include, but are not limited to, a laceration, puncture, heavy blow, fracture and crush injury.
- (9)having carpal tunnel release involving the wrist on the affected side, within the one year before the clinical worsening of trigger finger;
- (10)having diabetes mellitus before the clinical worsening of trigger finger;
- (11)having a space occupying lesion involving the affected tendon or tendon sheath at the time of the clinical worsening of trigger finger;
Note: Examples of a space occupying lesion include, but are not limited to, amyloid deposit, gouty tophus, granuloma and post-surgery adhesion.
- (12)being treated with an aromatase inhibitor within the one year before the clinical worsening of trigger finger;
Note: Examples of aromatase inhibitors include, but are not limited to, anastrozole, exemestane and letrozole.
- (13)inability to obtain appropriate clinical management for trigger finger;
Aggravation-only factors: the factors in subsections 8(7) to 8(13) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
Balance of Probabilities (BoP) — Statement of Principles No. 40 of 2019
11 factors
At least one of the following factors must exist before it can be said that, on the balance of probabilities, trigger finger or death from trigger finger is connected with the circumstances of a person's relevant service:
- (1)performing repetitive activities or forceful activities using the affected hand, for a cumulative period of at least 500 hours within the six months before the clinical onset of trigger finger;
Note: forceful activities and repetitive activities are defined in the Schedule 1 - Dictionary.
- (2)having acute trauma involving the affected tendon or tendon sheath, within the one year before the clinical onset of trigger finger;
Note: Examples of acute trauma include, but are not limited to, a laceration, puncture, heavy blow, fracture and crush injury.
- (3)having diabetes mellitus before the clinical onset of trigger finger;
- (4)having a space occupying lesion involving the affected tendon or tendon sheath at the time of the clinical onset of trigger finger;
Note: Examples of a space occupying lesion include, but are not limited to, amyloid deposit, gouty tophus, granuloma and post-surgery adhesion.
- (5)being treated with an aromatase inhibitor within the one year before the clinical onset of trigger finger;
Note: Examples of aromatase inhibitors include, but are not limited to, anastrozole, exemestane and letrozole.
- (6)performing repetitive activities or forceful activities using the affected hand, for a cumulative period of at least 500 hours within the six months before the clinical worsening of trigger finger;
Note: forceful activities and repetitive activities are defined in the Schedule 1 - Dictionary.
- (7)having acute trauma involving the affected tendon or tendon sheath, within the one year before the clinical worsening of trigger finger;
Note: Examples of acute trauma include, but are not limited, to a laceration, puncture, heavy blow, fracture and crush injury.
- (8)having diabetes mellitus before the clinical worsening of trigger finger;
- (9)having a space occupying lesion involving the affected tendon or tendon sheath at the time of the clinical worsening of trigger finger;
Note: Examples of a space occupying lesion include, but are not limited to, amyloid deposit, gouty tophus, granuloma and post-surgery adhesion.
- (10)being treated with an aromatase inhibitor within the one year before the clinical worsening of trigger finger;
Note: Examples of aromatase inhibitors include, but are not limited to, anastrozole, exemestane and letrozole.
- (11)inability to obtain appropriate clinical management for trigger finger;
Aggravation-only factors: the factors in subsections 8(6) to 8(11) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
