Trigger Finger

Trigger finger is otherwise called as stenosing tenovaginosis. This condition affects the way the tendons move. A tendon is a cord of fibrous tissue that attaches the muscles to the bones. In this condition, the tendon between the forearm and finger muscles gets affected. The easy run of the tendon is inhibited and the causative factors are several including diabetes, rheumatoid arthritis etc. The tendons get thickened and on bending the finger a painful click is what results. In few instances a nodule or a bump may be present on the tendon. It mostly affects the thumb, middle and ring fingers. Both the hands are likely to develop this condition.

It can happen in anyone in spite of their health status. However women are found to be more prone to develop this condition. Continuous use of hands and forceful gripping of objects may increase the likelihood of developing this condition.

Symptoms are stiffness and clicking sound as one moves the fingers, a bump at the bottom of the finger that is affected, difficulty in straightening a bent finger.

Treatment

Treatment options are strictly based up on the extent of the condition. In case of mild symptoms, the following measures may be useful:

• Keeping the affected hand inactivated.
• Applying ice packs over the fingers.
• Performing mild finger exercises.
• Keeping the hand dipped in a bowl of warm water particularly in the morning hours.
• Applying a finger splint to immobilize the fingers.
• Massaging to minimise the pain.

In case of severe manifestations:

Non-steroidal anti-inflammatory drugs (NSAIDs), for example ibuprofen, can reduce swelling and relieve pain.
A cortisone injection can give fast relief from pain and swelling once injected to the fingers.
Trigger finger release surgery.

Surgery

Trigger finger release is a trouble-free surgery to correct a locked finger. The surgery is easy to perform and won’t take more than twenty minutes. The surgery is done under local anaesthesia. The steps are as follows:

• The patient will be given local anaesthesia.
• A minute incision is made over the crease.
• The tendon is then properly aligned.
• The incision is stitched.

In case of rheumatoid arthritis, tenosynovectomy is the preferred mode of treatment.

Percutaneous trigger finger release

A percutaneous trigger finger release is done under local anaesthesia and is not in wide practice.
In most of the cases this condition is not more than a nuisance and need not worry if prompt management is received.

Risks

A trigger finger release involves the following risks:

• Infection
• Damage to the nerves – The damage often is irreversible.
• Stiff sensation of the finger.
• Complex Regional Pain Syndrome (CRPS) – This is common and is featured with pain, stiffness and swelling following surgery. It usually gets corrected automatically but not to the full extend.

Recovery

Soon after the surgery, the person will be able to move the fingers effortlessly. Complete recovery is possible by 2 weeks. Physiotherapy can be of great use.