What is trigger finger syndrome?
Trigger finger arises when the smooth running of the tendon is blocked by a thickening of the tendon jamming against the constriction of the first pulley as it enters the finger. The flexed finger can no longer smoothly straighten and this causes pain and tenderness. When it suddenly straightens there may be a painful click. In severe cases, patients may need to use the other hand to straighten the affected finger.
The tendons which move the fingers and thumb, run in special lubricated tunnels called sheaths. Within the sheath-walls are strong fibrous bands called pulleys which confine the tendons close to the bones of the finger so that they do not ‘bowstring’ when the fingers are curled.
What treatment is available?
The initial treatment of trigger finger may involve splinting, and avoidance of activities that worsen the condition. Steroid injections can be performed in the outpatient clinic and can provide a complete resolution in mild cases, and relief in more severe cases.
The surgical treatment of trigger finger is usually carried out under local anaesthetic. A small incision is made at the base of the finger. Whilst protecting the nerves to the finger, the surgeon releases the tight pulley, and after checking that the tendon moves freely, the skin is sutured. A dressing is required for 10-14 days, but light activities can be performed during this time. As with all hand surgery, we recommend elevating the hand as much as possible during the recovery period.
