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Trigger Finger

Trigger finger (stenosing tenosynovitis) presents as a finger that bends and locks in place, with patients then having difficulty straightening the finger. The condition can also affect the thumb.
The cause of this condition is due to a tendon lining that develops a nodule or swelling with constant friction. This nodule gets stuck on one side of the tendon sheath, and is unable to glide smoothly, also preventing the tendon from straightening.
This condition can involve one or multiple fingers but surgery normally improves the function of affected limbs.

Diagnosis is clinical, however an ultrasound will help precisely locate a nodule in the flexor tendon.

The Procedure
Steroid injection can offer temporary relief. Surgery on the affected area (to release the A1 pulley) is a definitive treatment, and can be performed under general anaesthetic with the aid of a tourniquet.

The wound is dressed with a light bandage.  The patient is instructed to elevate the hand in a sling for a few days.
A plastic bag is used to protect the dressing for showers. Some bruising is normal.
The patient is encouraged to exercise the fingers as much as possible. Sutures are normally removed after 2 to 3 weeks.
As part of patient recovery, hand exercises will need to be upheld for a couple of months, to prevent adhesions in the wound or the formation of dense scar tissue.


The Risks

Early complications include bleeding, wound infection, swelling and stiffness, abnormal scarring, slow healing, wound dehiscence, damage to a nerve, persistent numbness, and complex regional hand syndrome. Later complications include prolonged swelling and stiffness.

Image by Dustin Humes
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