Trigger finger is a condition that occurs in the flexor tendons of the hand that control finger movement. Classically the patient complains that on flexing the fingers they are unable to straighten one of the fingers without using the other hand to force it open. This commonly occurs whilst you are asleep. On waking one notices a fixed, flexed finger. This can be painful, but the pain tends to be in the palm and this is where the tendon is catching the opening of a well defined tunnel, through which the tendon runs to the tip of the finger.
It is often difficult to find the cause of trigger finger. Tasks that require repeated grasping or the prolonged use of tools (scissors, screwdrivers) that press on the tendon sheath at the base of the finger or thumb may also irritate the tendons and the tendon sheath, causing them to thicken.
Trigger finger has also been associated with other conditions including rheumatoid arthritis, gout and metabolic disorders like diabetes.
In the first instance is a steroid injection into the affected area, works well in about 75% of patients, but the problem can recur a 3-6 months later. If the Trigger Finger cannot be corrected with a steroid injection, surgery is an option. This is usually done under a local anaesthetic to the palm and a small incision is made through the skin and the opening to the flexor tunnel is released. It takes about 30 minutes and is done a day case.
The patient is encouraged to open and close their hand, post-operatively and hand therapy may be needed if the fingers remain stiff. The dressing will be changed and the wound checked 10-14 days after surgery when the stitches will also be removed.
Of course, we use the very latest technology. But our real skill is in knowing how and when to use it to suit each individual patient.MR BRYAN MAYOU, FOUNDER