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Mar 23, 2023
Your fingers have tendons which control the straightening, or extension, and the bending, or flexion, of your fingers. Unfortunately, the flexor tendons which lie on the palmar surface of your fingers and hand can get stuck in their, normally smooth, tunnel in your palm. This temporary catching, or sticking, of a flexed finger that is in the process of extending, is the "triggering".
The severity of the triggering can be mild where the finger can click with motion. However, it can be more severe when the finger actually gets stuck in a flexed position, requiring a forceful extension to get unstuck or even requiring the help of your other hand to force the finger straight.
This can be very painful. In the most severe cases; however, the finger is stuck in the flexed position and cannot be forcibly straightened.
This condition is treated with splints, steroid injections, or even trigger finger release surgery. Here’s what you need to know about it!
In short, the tendon gets stuck in the palm. The flexor tendons are kept close to your finger bones by a series of tunnels that run from the palm to the fingertip. They are called pulleys. The pulley in the palm, the A1 pulley to be precise, becomes swollen and constructs the flexor tendons of the finger.
As this construction worsens, the tendon swells on either side of the pulley. At some point, the tendon can no longer glide smoothly through the pulley with a normal range of motion. So, as you extend the finger, the swollen flexor tendon tries to squeeze through the swollen pulley. The force builds up, and then suddenly - pops - the tendon passes through. This presents as triggering.
The exact reason why the pulley gets swollen is not clear. Most of the time, we don't have a good explanation. However, it is more common in patients with overuse issues, forceful and repetitive power grip, and diabetics.
Now, when it comes to risky groups, it is noticed that this condition is more likely to develop in diabetics and women over 50.
It’s important to note that the severity of your condition and your response to treatment is not tied to the activity. It’s not like one job or hobby has a higher chance of sending you straight to trigger finger surgery. This mostly comes down to pain level and your response to non-surgical treatment.
As we’ve already mentioned, the first thing you might notice is that your fingers are stiff, especially in the morning. Some patients feel a bump or mass in the palm of their hand - that is the swollen pulley. The triggering is usually the last presenting symptom.
When the finger moves, you may also hear a popping or a clicking sound, even if the finger does not get stuck. This is trigger finger developing.
It is also important to stress that while it is the most likely to affect the ring finger and the thumb, it could affect any finger. It’s also worth mentioning that due to a palpable bump in hand and a stuck, flexed finger, it can be confused with Duputren’s contracture.
There are several non-surgical treatments for the trigger finger.
Sometimes, you just need to get some rest. We’ve already listed activities that are putting you at risk, but you likely know some similar activities that are a part of your routine. Some people find the temptations irresistible; this is why wearing a finger splint can be effective.
There are also some exercises for the trigger finger. In general, you’re aiming to improve the mobility of the finger. So, exercises like hand clenches, fingertip bend, finger spread, towel grasp, fingertip, and middle joint bend, may be effective.
Lastly, since the inflammation is causing the problem, steroid injections are usually very effective.
If none of these methods work, you should seek a trigger finger specialist and inquire about the surgery.
The surgical procedure is fairly simple. It usually doesn’t take more than 10 minutes, and it’s usually performed under just local anesthesia.
A surgeon makes a small cut on the palm of your hand, about 10-15mm, and then cuts open the A1 pulley, and then the surgeon will ask you to flex and extend the fingers to make sure the triggering has stopped. And that’s it. This incision will allow the tendon to glide through the A1 pulley without getting stuck.
What is the success rate of surgery for a trigger finger?
The success rate of trigger finger surgery is over 90%. However, if patients do not move their fingers much after surgery, they may get some stiffness. Otherwise, recovery is usually quick, with office work permitted immediately. Manual labor jobs may take 4-6 weeks of recovery.
How long does recovering from trigger finger surgery take?
Since it’s a minor hand surgery, you head home on the same day. Generally, you should keep your hand raised and bandaged for about two days. Moreover, applying some of the exercises that we’ve previously mentioned is a good idea.
Now, full recovery will probably take about six weeks. This is how long it can take for everything to be like before.
However, if you’re not using your hands too much, you could return to work in 1-2 days. The most important part is to ask your doctor for advice before doing so. Either way, they’ll tell you how long your recovery from hand surgery should take.
What are some problems after trigger finger surgery?
If the surgery is done right, there should be no side effects. However, like any other surgery, wound infection, allergic reaction (to medication, materials, or equipment), and bleeding are possible. Scar tissue can also be robust in some patients, which is difficult to predict before trigger finger surgery.
It’s also worth mentioning that, for many people, this condition corrects itself. With enough rest, the problem could disappear on its own; however, it didn’t appear randomly to begin with. As we’ve already mentioned, if resting and steroids fail, there’s always surgery. Trigger finger surgery has a success rate of 90%, a recurrence rate of less than 3%, and it doesn’t take more than 10 minutes. As far as last-resort solutions go, this one doesn’t seem that bad.
For those who want to inquire about their specific case, you should find a trigger finger surgeon at the Orthopedic Institute of New Jersey for a consultation.
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