Why Does it Occur?
Trigger finger is one of the most common disorders in the hand, and seems to be increasing in incidence, possibly due to increase usage of our hands with computing and other activites. Trigger finger is typically caused by swelling of the flexor tendon that can then catch as the tendon glides underneath the tendon sheath tunnels. It often occurs because of overuse of the hand, or because of any disorders that causes swelling in the hand. It also occurs more commonly in patients with certain medical conditions such as Diabetes, inflammatory disorders such as Rheumatoid Arthritis, or in patients who have a history of other overuse-type disorders such as Carpal Tunnel Syndrome or DeQuervain's Disease.
Trigger finger often causes pain at the palmar base of your finger especially with gripping. Often a clicking or locking sensation is associated with the pain. When severe enough, the finger(s) can become stuck such that it cannot be extended or flexed without help, or even with help from the other hand. It is not uncommon for multiple fingers to be involved, including the opposite hand.
Dr. Steven Lee will usually order an X-ray to help rule out other diagnoses. Other diagnostic modalities such as Ultrasound or MRI may be performed if needed.
Rest and activity modifications to back down on gripping or overuse is recommended. Typically up to 3 cortisone injections, 1 month apart can be attempted safely depending on the patient's response to the cortisone. We have ultrasound guided injections to insure accurate placement of the injections. Anti-inflammatory medications (if not contraindicated for other medical reasons) can also be helpful the help bring the swelling down and alleviate symptoms.
Surgery may be recommended if you have not improved with non-operative treatment, or if your trigger finger becomes severe enough that your finger becomes locked in place and is unable to be unlocked. The surgery for trigger finger typically takes about 5 minutes to perform and involves releasing one of the tunnels to make more room for the tendon as well as cleaning the inflammatory tissue off of the tendon. This surgery is typically performed as an outpatient, and movement of your fingers is encouraged right away.
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After surgery, a soft dressing will be placed on your hand that must be kept clean and dry. After a week, the dressing is removed in office, and we will most likely remove your sutures at that time. Hand Therapy (OT) is then advised for approximately 4 weeks. After surgery you may have some sensitivity at the incision site especially with gripping which should go away after about 4 weeks. Hand Therapy is important to help decrease scar tissue, decrease hypersensitivity, and improve range of motion.
Immediate Post-Operative Instructions
Please refer to the following pages for more information:
*It is important to note that all of the information above is not specific to anyone and is subject to change based on many different factors including but not limited to individual patient, diagnosis, and treatment specific variables. It is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopedic advice or assistance should consult Dr. Steven Lee or an orthopedic specialist of your choice.
*Dr. Steven Lee is a board certified orthopedic surgeon and is double fellowship trained in the areas of Hand and Upper Extremity Surgery, and Sports Medicine. He has offices in New York City, Scarsdale, and Westbury Long Island.