Trigger finger release



Trigger finger release

Trigger finger occurs where there is a thickening on or around the tendon, which catches on a pulley at the base of the finger or thumb. When you bend your finger down it gets locked in a bent position and is often difficult or painful to fully straighten it. You can often feel a small lump in the palm of the hand. This can happen in any and sometimes multiple fingers.

Treatment

Steroid injections- a steroid injection around the tendon can help the swelling settle down and allow the tendon to glide freely. The injection takes time to work and may take up to 6 weeks to resolve the problem. The injection is uncomfortable and can take a few days for the hand to settle down. Even if the triggering is resolved, triggering may return in the same or other fingers at a later date; this is more common in diabetics.

Surgery- If the injections have not worked then surgery is considered, this is carried out as a day case procedure. The area is numbed with local anaesthetic injections. A small incision is made in the palm and the tendon pulley is released so that the tendon can run freely. The hand is bandaged with the fingers freely moving. The bandage can be removed at 5 days. The wound is kept clean, dry and covered until the skin has healed which is usually 2 weeks, and the stitches have dissolved.

All procedures have associated small risks, they include

Infection- any operation can be complicated by infection and this would be treated with antibiotics

Tender scars- the scar is tender to begin with but improves with mobilisation and massaging with cream.

Bleeding-sometimes this can cause a problem with the wound, and you should tell your surgeon if you are on aspirin or anticoagulants.

Severe pain, stiffness (chronic regional pain syndrome)- a small number of people get a swollen, stiff, painful hand after any hand operation. This cannot be predicted, but taking regular pain relief, elevating and mobilising the hand helps initially and physiotherapy treatment is required.

Nerve damage- the nerves running to the fingers may be damaged at the time of surgery and may cause numbness in the finger, this is rare.

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