Trigger Finger

Understanding Trigger Finger

Trigger finger, also known as stenosing tenosynovitis, is a condition that affects the tendons in your hand. Tendons are cords that attach muscles to bones. In trigger finger, the tendon sheath (the tunnel the tendon slides through) becomes narrowed, making it difficult for the tendon to move smoothly. This can cause pain, stiffness, and a popping or catching sensation when you bend or straighten your finger.

Symptoms of Trigger Finger

Common symptoms include:

• Pain at the base of the affected finger or thumb.
• Stiffness, especially in the morning.
• A popping or clicking sensation when you move the finger.
• A lump or nodule in the palm at the base of the affected finger.
• The finger locking in a bent position, then suddenly straightening (triggering).
• In severe cases, the finger may be permanently bent.

Diagnosis

Diagnosis is typically made through a physical examination. Your doctor will ask about your

symptoms and examine your hand to feel for tenderness, swelling, or a nodule. They will also

observe the range of motion in your fingers. X-rays are usually not necessary, as trigger finger

primarily affects the soft tissues.

Surgical Treatment

Surgery is considered when non-surgical treatments, such as splinting and cortisone injections, have not provided sufficient relief. The goal of surgery is to release the constricted tendon sheath, allowing the tendon to glide freely again.

Procedure:

Typically a day case procedure. Usually performed under local anaesthesia.

Small incision in the palm at the base of the affected

finger. During surgery, the surgeon will make a small incision in your palm near the base of the affected finger. They will then carefully cut the A1 pulley (the thickened portion of the tendon sheath) to widen the tunnel and allow the tendon to glide smoothly. The skin is then closed with sutures. The A1 pulley is one of several that keeps the tendons close to the bone. Cutting this pulley does not usually weaken the hand.

Potential Risks and Complications

As with any surgical procedure, there are potential risks and complications, including:

• Infection: Although rare, infection can occur. Antibiotics may be necessary.
• Nerve injury: There is a small risk of injury to the digital nerves that provide sensation to the finger. This could result in numbness or tingling.
• Tendon injury: Very rare, but possible.
• Pain and stiffness: Some pain and stiffness are expected after surgery but usually resolve with hand therapy exercises.
• Scarring: A scar will form at the incision site. In some cases, the scar tissue can be thick or sensitive.
• Incomplete release: In rare cases, the triggering may not be completely resolved with surgery, and further treatment may be needed.
• Complex Regional Pain Syndrome (CRPS): A rare condition causing chronic pain.

Expected Outcomes and Recovery

Most people experience significant improvement after trigger finger surgery. The triggering and

locking sensation should be eliminated, and pain should be reduced.

Recovery involves:

Hand therapy: Specific exercises to improve range of motion and reduce stiffness.

Wound and scar management: Keeping the incision clean and dry. Massaging the scar once healed.

Pain management: Taking pain medication as prescribed. Simple pain killers like paracetamol or Ibuprofen are usually sufficient.

Return to activities: Gradual return to normal activities as tolerated. Avoid heavy lifting or

repetitive gripping initially.

Full recovery may take several weeks to months. It's important to follow instructions and do exercises .

Next StepsIf you have any questions or concerns about trigger finger surgery, please do not hesitate to contact us on the helpline. We can provide you with personalized information and guidance to help you make informed decisions about your treatment.