Trigger Finger
Trigger Finger, also known as stenosing tenosynovitis, is a condition where one of the fingers or thumb of the hand is caught in a bent position. The affected digit may straighten with a quick snap, similar to pulling and releasing the trigger on a gun, hence the name trigger finger.
Signs And Symptoms
Commonly reported symptoms associated with trigger finger include the following:
- Soreness or a bump at the base of the finger where the finger joins the palm.
- Bent finger suddenly pops out and straightens
- Finger movement creates a “popping” or “clicking” sound or sensation
- Finger feels stiff and sore
- Finger becomes bent with inability to straighten
- Symptoms are worse in morning
Causes
Trigger finger happens when the tendon that controls that finger can’t glide smoothly in the sheath (tenosynovium) that surrounds it. This may occur if part of the tendon sheath becomes swollen. Long-term irritation of the tendon sheath can lead to scarring and thickening that affect the tendon’s motion. When this happens, bending your finger or thumb pulls the inflamed tendon through a narrowed sheath and makes it snap or pop.
Diagnosis
Trigger finger is diagnosed based on the medical history and physical examination and without any special testing required.
Non-Operative Treatment
Most primary trigger digits in adults can be successfully treated non-surgically with the use of a steroid injection. This has a low complication rate and is successful in up to 75% of cases, depending on chronicity – i.e. the longer you have had the trigger the less likely a steroid injection will fix it. Diabetics may experience a transient rise in blood glucose levels. Splinting can be considered and is effective 50-60% of the time.
Surgical Procedure
- Percutaneous Release: Patients are allowed to immediately use and wet their hands. The band-aid can be removed within a few hours.
- Open Release : Patients are advised to wear the bandage until the sutures are removed 10 to 14 days after surgery. They are not allowed to wet their hands until that time. Use of hand is limited for 2-3 weeks.
Risks and Complications
As with any surgery there are potential risks involved. The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages. Dr Zadeh informs you of these risks before the surgery takes place.
The majority of patients suffer no complications especially following percutaneous trigger finger release (Needle Technique) ; however, complications occur more frequently with open trigger finger release and may include:
- Infection
- Nerve damage
- Sensitive scar (open technique)
- Stiffness to the finger
- Trigger finger returns
Risk factors that can negatively affect adequate healing after surgery include:
- Poor nutrition
- Smoking
- Alcoholism
- Chronic illness
- Steroid use