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    Trigger Finger

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    streeturban
    Trigger finger is caused by thickening of the tendon sheath that causes the tendon to get caught when moving in and out of the finger. It can be treated with steroid injections, which flatten the swelling and allow free movement in 75% of cases. Surgery is needed if injections don't work, which involves cutting the pulley to prevent the tendon from catching. The operation has minimal risks but some potential complications include stiffness, numbness, and regional pain syndrome in rare cases.

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    Trigger Finger

    Uploaded by

    streeturban
    26 views1 page
    Trigger finger is caused by thickening of the tendon sheath that causes the tendon to get caught when moving in and out of the finger. It can be treated with steroid injections, which flatten the swelling and allow free movement in 75% of cases. Surgery is needed if injections don't work, which involves cutting the pulley to prevent the tendon from catching. The operation has minimal risks but some potential complications include stiffness, numbness, and regional pain syndrome in rare cases.

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    Trigger finger is caused by thickening of the tendon sheath that causes the tendon to get caught when moving in and out of the finger. It can be treated with steroid injections, which flatten the swelling and allow free movement in 75% of cases. Surgery is needed if injections don't work, which involves cutting the pulley to prevent the tendon from catching. The operation has minimal risks but some potential complications include stiffness, numbness, and regional pain syndrome in rare cases.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    26 views1 page

    Trigger Finger

    Uploaded by

    streeturban
    Trigger finger is caused by thickening of the tendon sheath that causes the tendon to get caught when moving in and out of the finger. It can be treated with steroid injections, which flatten the swelling and allow free movement in 75% of cases. Surgery is needed if injections don't work, which involves cutting the pulley to prevent the tendon from catching. The operation has minimal risks but some potential complications include stiffness, numbness, and regional pain syndrome in rare cases.

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    TRIGGER FINGER

    H.J .C.R. Belcher, MS, FRCS (Plast) www.harry-belcher.co.uk/home.htm HJ CRB2013


    The flexor tendons that bend the fingers and thumb run from the
    forearm. The tendons run within a tube called the flexor sheath.
    This has a complex system of thickenings called annular pulleys.
    There are five in the fingers (A1-A5) and three in the thumb (A1,
    oblique and A2). The whole system is mechanically very similar to
    bicycle brake cable.
    The tendons are lined by a layer of tissue called the tenosynovium.
    This allows them to glide smoothly through the various pulleys. As
    we age, the tenosynovium degenerates and thickens, a condition
    called tenosynovitis. This in alone can make the fingers feel puffy,
    tender, slow and even stiff.
    Trigger finger is caused by the thickening around and on the tendon, which causes it to
    catch as it runs in and out of the sheath. You can often feel this swelling in the palm as
    you move the finger. The condition can occur in any and sometimes multiple fingers.
    There are two ways of treating the problem.
    Steroid injection A small amount of steroid is injected around the tendon. This flattens
    out the swelling on the tendon allowing it to glide freely in
    and out of the sheath once more. A single injection is all that
    is needed in 50% of cases. A further 25% will respond to
    another injection (i.e. three-quarters of cases can be
    successfully treated in this way). The steroid injection does
    not work immediately. It causes no general side-effects but
    occasionally the skin around the injection-site can be made a
    little thinner. Therefore two injections are the maximum for
    the treatment of each episode. Even after successful
    treatment, the triggering may return in the affected or other
    fingers. This is, however, very unusual if you have had surgery
    Surgery This is needed if the steroid injections do not work. It involves a small procedure
    under local anaesthetic. A slit is made in the mouth of the
    sheath to prevent the tendon catching at this point.
    Technically, this is achieved by the surgeon cutting the A1
    pulley.
    The operation is usually performed under local anaesthetic.
    The hand will be dressed with a supportive dressing that
    permits finger movement and light hand use. You will be
    discharged with specific instructions (Hand Surgery) relating
    to hand exercises and wound care. Your stitches will be
    dissolving by about two weeks after your operation.
    Wound Possible problems include swelling, bruising, bleeding, blood collection under the wound
    (haematoma), infection and splitting of the wound (dehiscence).
    Scar You will have a scar on the palm, which will be firm to touch and tender for some months. This can be
    helped by firm massage with the moisturizing cream.
    Stiffness Some patients can have finger stiffness before the operation due to poor tendon glide. Exercise is
    important to overcome both this and the effects of surgery.
    Nerve The nerves running to the fingers can be damaged during the surgery and cause numbness in part of
    the finger. This complication is very rare and the nerve would be repaired.
    Regional pain syndrome About 5% (1 in 20) of people are sensitive to hand surgery and their hand may
    become swollen, painful and stiff after the operation. This problem cannot be predicted, is variable in
    severity and is principally treated with physiotherapy.

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