Trigger Finger / Trigger Thumb

The Condition

Tendons slide in and out of a tube-like lining. Trigger finger is caused by thickening of the lining of the tendon (or the tendon sheath) which stops the normal smooth movement of the tendon inside the sheath, as it glides there and back.

The Operation

Thickening of the tendon sheath is treated by a small wound over the site of the thickening. The tendon lining is divided and this allows plenty of space for the tendon to glide in. The tendon sheath will re-grow but it will re-grow to a much larger size and prevent any trapping of the tendon.

The wound is closed with glue or stitches. Local anaesthetic is put in the wound at the end of the operation. This keeps the finger and wound numb for about 6 – 8 hours, when it wears off there will only be a slight ache. A small dressing is usually put on and covered with a large bandage.

After the Operation

After surgery, you will be able to move your finger or thumb immediately very freely and quite normally from the day of the operation.

The large dressing that will be put on at the time of surgery can be removed by you the day after the operation, but keep on the small dressing that will cover the wound.

If stitches have been put in during the operation (as opposed to using glue) they will be removed in the clinic 10-14 days after surgery. If glue has been used, that will wash off. The results of surgery are very good with about 100% success. You should not get triggering again in the finger that has been operated on.

Risks of Surgery

1. Wound tenderness and sensitivity occurs in less than 2% of operations and usually settles by 6 weeks after the operation. Occasionally an injection is needed to cure the sensitivity but this is very rare – under 0.5% of all operations.
2. The wound may be noticeable – about 1% of all operations
3. After any cut, it is possible to get infection – about 1 – 2% of all operations.
4. Circulation disturbance (sympathetic dystrophy or regional pain syndrome) can occur in approx 1% of all operations. Prompt treatment with medication or injection is usually very effective. You will be reviewed regularly after surgery so this or an other complication, is treated promptly.

References

Green – Textbook of Hand Surgery
Bulstrode – Textbook of Orthopaedic Surgery
Internet sites: www.mayoclinic.com     www.orthogate.com