Reading
Berkshire
Harley Street
London
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Trigger finger
What?
Trigger finger (Stenosing tenosynovitis) is a condition which makes yours fingers or thumb difficult and painful to bend or straighten. The affects fingers become 'locked' in a bent position and have to be manually pulled straight by the other hand.
Commonly a popping or clicking sound is felt when the finger pulled straight.
Why?
To enable your finger to bend on the palm side of your hands are tendons which act like ropes that are attached to muscles.
The tendons on the palm side of the hand (flexor tendons) are held in place by strong bands of tissue, known as Pulleys, which are shaped in arches over the tendon. There are a number of pulleys but the primary affected pulley causing triggering is the A1 pulley.
The tendons run inside a protective lubricated sheath which allows them to glide smoothly when the fingers are bent and straightened.
Trigger finger occurs when the tendon or sheath becomes or inflamed meaning the tendon can no longer slide easily through the sheath causing it to bunch up to form a small lump (nodule).
Who?
Trigger finger affects approximately 2% of the population. Most of the time the exact cause is unknown but people who are diabetic are at higher risk of developing trigger finger.
How?
Diagnosis:
The diagnosis of a Tigger finger or thumb is made by examining your hands. The most common fingers affected are the middle finger and ring finger.
Treatment:
The first line of treatment is an ultrasound guided steroid injection into the area that is inflamed (A1 pulley). If your fingers tend to lock in the night then I suggest wearing a trigger finger splint for 8 weeks.
Over 90% of patients symptoms are totally resolved with non-operative treatment.
Surgery:
Surgery is indicated if symptoms do not settle after a steroid injection. Surgery is performed under local anaesthetic as a day case. A small incision is made on your palm and the thickened tissue is released to allow the tendon to glide easily.
Me?
Surgery is generally low risk as it performed under Local Anesthetic.
Success rates for surgery are 95%. Complications risks (1-3%) include recurrence, infection, nerve, tendon and vessel damage, Stiffness, CRPS.