WHAT YOU SHOULD KNOW
This condition is often referred to as trigger finger or trigger thumb. The tendons that bend the fingers move back and forth in a narrow tunnel that begins at the edge of the palm. Normal everyday use or any pressure over that area can initiate swelling. Once swelling begins, there is friction from the tendons rubbing back and forth that leads to more swelling and the vicious cycle then just keeps on going until something is done.
MEDICAL HISTORY
Patients usually complain about a sense of stiffness trying to move the digit. This can be accompanied by pain and is usually worse in the morning. Sometimes the digit will actually get stuck and need to “pop” or “click” to free itself and move again. When the condition becomes the most severe, the patient needs to use the other hand to free up the digit and permanent joint contractures (inability to move the joint normally) can result.
EXAMINATION
Applying pressure on the edge of the palm will identify a tender lump that moves with the tendon and sometimes a “click” with each movement.
ADDITIONAL TESTS
None are needed.
TREATMENT OPTIONS
| NON-OPERATIVE | SURGICAL RELEASE | |
| CONSISTS OF | Cortisone injections to shrink swelling around tendons | Simple release of constricting band to make more space for tendons |
| FEATURES | Limit of 2 total injections | Local anesthesia, outpatient, minimal incision |
| ADVANTAGES | Avoids surgery | Definitive solution to problem |
| DISADVANTAGES | Not effective for moderate to advanced conditions | Requires surgery |
RECOVERY
Sutures are removed in the office 2 weeks after surgery. Until that time, the small wound must be kept clean and dry. Otherwise, there are no formal restrictions of any kind, and patients are encouraged to use the hand for all normal everyday activities. There will be some soreness because the body has had an intervention. Daily exercises to move the tendons that have now been freed must be done to prevent stiffness.
