Trigger finger is usually caused by swelling of one of the tendons that run along your fingers and thumbs.
The swelling makes it difficult for the affected tendon to slide through its membrane (tendon sheath), causing the pain and stiffness associated with trigger finger.
The swelling can cause a section of the tendon to become bunched into a small lump (nodule) at the base of the affected finger or thumb.
If a nodule forms, the tendon can get trapped in the tendon sheath, causing the affected finger or thumb to become temporarily stuck in a bent position. The affected tendon may then suddenly break free, releasing your finger like the release of a trigger.
Trigger mechanisms may be inflammatory conditions, previous hand injury however sometimes exact reason for its occurrence are unknown.
The tendons on the palm side of the hand (flexor tendons) are held in place by strong bands of tissue, known as ligaments, which are shaped in arches over the tendon. The tendons are covered by a protective sheath which produces a small amount of fluid to keep the tendons lubricated. This allows them to move freely and smoothly within the sheath when the fingers are bent and straightened.
Trigger finger occurs if there’s a problem with the tendon or sheath, such as inflammation and swelling. The tendon can no longer slide easily through the sheath and can bunch up to form a small lump (nodule). This makes bending the affected finger or thumb difficult. If the tendon gets caught in the sheath, the finger can click painfully as it’s straightened.
pain at the base of the affected finger or thumb when you move it or press on it, and stiffness or clicking when you move the affected finger or thumb, particularly first thing in the morning.
Trigger finger is most common in middle aged women.
Trigger finger is diagnosed by feeling tendon swelling and pain while moving the affected finger. RTG will eliminate other reasons for the pain.
Conservative treatment consists of corticosteroid injection and reducing movement. In this case reoccurrence is quite common, as this doesn’t treat causes.
Most effective and practicli only effective method is surgical, usualy performed under local anesthetic. Procedure takes aprox 30 min under local anesthetic, patient may leave the clinic almost imediately. Surgery involves releasing the affected sheath by making a small incision (15 mm) in the palm of your hand along one of the natural creases, which may mean the scar will be less noticeable, to allow the tendon to move freely again.
Outpatient procedure under local anesthetic is Surgial solution.
Post operative care
Its recommended patient wears a sling to keep the hand elevated, which will reduce swelling or bleeding. Passive and active excercises will prevent reocurance. Stitches are removed after 14 days post surgery.
Next step will be looking after the sacar, pressure massage, aplication of silicone strips to the scar (Epiderm, Scarban). Patients may return to work in two to three weeks. Sometimes earlier.