Trigger Finger

In trigger finger (stenosing tenosynovitis), you get a locking or clicking of a nodule on your tendon when you try to bend your finger or thumb.

One of the first signs of trigger finger is the development of a tender spot on the palm of the hand. This tender area can then become a nodule or bump on the flexor tendon and can grow large enough that it gets caught up under the straps that hold the tendon in place.

Trigger finger can be family-related or the result of an injury or chronic repetitive movements. Trigger thumb is more common in diabetics.

Often trigger finger is worst first thing in the morning and people often find the finger locks or clicks when they try to bend it and they sometimes need to use their other hand to release the finger. This can be very painful. Rest can sometimes make it better but it often returns once you resume any activity that is manual work-related. One or two steroid injections approximately 6 weeks apart can help up to 75% of people. If this does not resolve the clicking completely, a release of the A1 pulley or strap is needed.

Surgery 

Trigger finger release is done under local freezing while you are awake. There is a blood pressure cuff on your arm that is inflated during the surgery. You can eat and drink before the surgery. The surgery takes about 10 minutes and is only done if you can demonstrate locking or clicking at the time of surgery.

Recovery

You will need someone to drive you home from the hospital. You can shower 48 hours after surgery. Wound care is simply washing then applying ointment and a light dressing every one or two days. The sutures will fall out in about 10-14 days. Dr. MacDonald will see you 10-14 days after surgery to ensure you are healing well.

If you have a very physical job, you should plan to have 4-6 weeks of healing time. If you have a fairly sedentary job, then you may be able to return to work as early as 2-3 weeks after surgery. Aside from than minimal daily activities such as dressing or feeding yourself, you need to avoid activities that may increase your blood pressure or require use of your hand.

Complications 

As in any surgery, risks include infection, scarring, delayed wound healing, bruising or bleeding, and incomplete release or recurrence. Complications in this procedure are relatively uncommon but will be discussed further at the time of consultation. The severity of your nerve injury will often determine how much relief you will get from the surgery.