What is trigger finger and how is it treated?

Transcript

Let's take a look at trigger finger surgery. Trigger finger is one of the most common conditions that a hand surgeon treats. Occurs most commonly from frequent, uh, keyboard use, as you can see here, frequent texting. Anything repetitive that causes the fingers or thumbs to move, uh, can cause this problem. As you can see here, this is the actual tri, it's a painful triggering condition where the finger snaps back and forth. Ring finger most common, but can occur in any digit.

And let's take a look at an animated anatomical picture here. The blue structures are the flexor tendons. There's two to each finger and one to the thumb, and they go through a little, these white bands, what we call pulley, and it's within these bands that you get the mechanical advantage to be able to bend the fingers into the palm.

As you can see from this picture, the, the fingers are being bent into the palm, and now as we straighten, you can see again the tendons are, are moving back and forth. Now, and it, when, what happens is from repetitive use you get a little nodule that forms in the palm on one of the tendons, and that nodule, uh, becomes larger over time from repeated friction.

And much like a little knot in, in a rope trying to go through a pulley, this nodule starts ramming into the flex, into the, uh, flexor sheath or pulley system, and it actually can grate back and forth causing this popping of the joint just beyond that, or the middle joint the finger. In severe cases the finger can actually become locked straight, but more commonly it's locked in a bent position.

Now initially when the patient comes in we will do a cortisone shot, effective in about 50% of cases. But you will see from an animated video here, we'll actually show you the surgical procedure. We make a little cut, local anesthetic, about a five minute outpatient procedure, a little light sedation. We actually cut the band that's, uh, impeding the tendon, and we open that up. That allows the finger to bend. We place several sutures, two or three, four sutures in place, and a little light dressing.

Now an actual picture or video of a, of a patient undergoing this procedure. You can see here putting the scissors right underneath this white structure here, the retractors are in place, we're snipping with the scissors that band. You can see a great picture here of that actual opening up of that band. In this case, of this patient, she had no flexion. Upon releasing her tendon immediately, once we awakened her during the procedure, she could bend the thumb.

So after the procedure it's about 10 days with a little light dressing or Band-Aid over the incision. You're moving it right away, uh, sutures come out 10 days later, and then it's about a four week total recovery, just because it's sensitive skin to place a cut on the hand. So it's about four weeks give or take for the, uh, all the soreness to go away, but activity is tolerated.

Now there's very little chance of recurrence with this condition, but what you will see, it'll pop up in other fingers over time, even as several months later, just from, uh, using the other hand or the same hand. You can get, you know, repetitive motion and get, and another one comes up. For more on this condition and many other conditions, visit our website at the Hand and Wrist Institute.