Jones The Hand
Trigger Finger/Thumb
What is trigger finger/thumb?
Trigger finger usually causes pain or clicking/catching when the finger is moved. Often both symptoms are present. It is usually worse in the morning, when the finger can get stuck in a bent position and requires some effort or assistance to straighten. The problem is tightness and swelling at the point where the tendon enters a tunnel at the base of the finger. It is usually not clear why the swelling starts, though it is thought it may be minor injury. The condition is more common in people with diabetes. If left alone, it does not usually get better unless there is a reversible cause.
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Fortunately, the condition can be readily treated. For most patients, one or two injections of steroid in the clinic will get rid of the condition permanently. Occasionally, this treatment doesn’t work or the problem comes back. Unfortunately, the injections are less successful in diabetic patients. In this situation, surgery is usually advised.
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Treatment
Surgery involves making a small cut at the base of the finger to slit open the entrance to the tunnel containing the tendon. The operation is done as a daycase under local anaesthetic. The wound heals in two weeks and must be kept clean and dry during this period. Dissolving stitches are normally used so they do not need to be removed.
Risks and Recovery
The patient can return to a light job as soon as they feel able (a few days to a few weeks). Heavy work may not be possible until six weeks. Return to driving depends entirely on the hand being strong enough and comfortable enough that the driver is not distracted and is in full control of the vehicle. This decision is the driver’s responsibility. A patient would usually reach this point at about 3 weeks.
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Risks from surgery include persistent symptoms, recurrence of symptoms and the need for further surgery, infection, bleeding, damage to nerves/vessels/tendons in the area, scarring, stiffness and a rare condition where the hand can overreact to the operation resulting in pain, stiffness and swelling for many months.
However, the operation is usually very successful and affords a permanent cure.
