What is Trigger Finger?

Trigger finger, also known as stenosing tenosynovitis, is a hand condition characterized by pain, stiffness, and abnormal movement during finger flexion and extension. It commonly affects the thumb, ring finger, or little finger. In the early stages, symptoms may be mild, presenting as slight discomfort and a clicking sensation; however, as the condition progresses, individuals may experience difficulty in extending the affected finger or thumb. While trigger finger typically does not lead to severe complications, untreated cases can result in the affected finger becoming permanently fixed in a flexed position.

 

The hallmark of trigger finger is the sensation of the finger catching or locking during movement, followed by a sudden release, reminiscent of a trigger mechanism. The affected finger may exhibit pain, swelling, and localized tenderness. In severe cases, the finger may be unable to extend independently and may require assistance from the opposite hand to straighten.

 

Etiology

The underlying cause of trigger finger is often related to issues with the flexor tendons or their sheaths. The flexor tendons are responsible for bending the fingers, and they glide through the tendon sheath at the joints. When problems occur with the tendons or tendon sheath, such as thickening or narrowing, the tendons may catch or lock during movement, leading to the symptoms associated with trigger finger.

 

Who is at Risk for Trigger Finger?

Trigger finger is a common hand condition that can occur in individuals of any age. However, certain groups are at higher risk:

 

• Middle-aged and Elderly Individuals: Trigger finger is most prevalent among middle-aged and older adults, particularly women. Age-related changes in finger tissue may increase the risk of developing the condition.
• Occupational Overuse: Professions or activities that require repetitive use of the fingers—such as assembly line workers, pianists, typists, and carpenters—may increase the risk of injury or inflammation, contributing to trigger finger.
• Hand-Intensive Activities: Certain sports and activities, including golf, softball, bowling, and volleyball, require frequent use of the fingers, particularly the thumb. These activities may elevate the risk of finger injury and trigger finger.
• Chronic Health Conditions: Certain diseases, such as diabetes, rheumatoid arthritis, and thyroid disorders, may increase susceptibility to trigger finger.
• Genetic Factors: Some individuals may have hereditary connective tissue disorders that predispose them to trigger finger.

 

Treatment: Trigger Finger Release

Trigger finger release is a surgical treatment option for addressing the condition. During the trigger finger release procedure, the surgeon makes an incision over the affected finger to relieve pressure on the flexor tendon or tendon sheath. The surgery involves cutting the tendon sheath to alleviate compression, allowing the finger to flex and extend normally.

 

Trigger finger release surgery is typically a relatively straightforward procedure and can be performed under monitored anesthesia care or local anesthesia. Postoperatively, patients often experience immediate restoration of finger movement, and the recovery period is generally short.

 

Preparation

• Fasting Requirements: Patients are typically required to fast for 6 hours prior to surgery, meaning no food intake during this period. A small amount of plain water is permitted until 2 hours before the procedure.
• Preoperative Medications: Please take any prescribed medications as directed. If you are currently taking blood-thinning medications, such as Aspirin, Warfarin, Xarelto, or Pradaxa, or any herbal supplements, inform your doctor as soon as possible.
• Informed Consent: The doctor will discuss the reasons for the procedure, the process involved, and any potential complications. After gaining a clear understanding, patients will be asked to sign the consent form.

 

​​​​​​​Follow-up and Recovery

• Activity: It is important to move your fingers frequently after surgery to promote circulation.
• Stitch Removal: Stitches may need to be removed approximately two weeks after the procedure.
• Postoperative Symptoms: Common symptoms may include headaches, dizziness, nausea, or inflammation at the venipuncture site. These typically resolve within a few days. Pain relievers may be taken as needed, and adequate rest is recommended.
• Eating: Patients should wait until the effects of anesthesia and sedatives have worn off before eating to prevent choking.
• Restrictions: Avoid alcohol, operating heavy machinery, or driving on the day of surgery to minimize the risk of accidents. Additionally, refrain from signing any legal documents for 24 hours post-surgery.
• Discharge: Patients may leave the facility once the effects of anesthesia have dissipated but must be accompanied by an adult.
• Rehabilitation Exercises: Follow your doctor’s or physical therapist’s recommendations for rehabilitation exercises. These will help restore strength, flexibility, and function to your fingers. Engage in these exercises gradually and moderately.
• When to Contact a Doctor: If you experience any pain, swelling, bleeding, signs of infection, or other unusual symptoms in your fingers, please contact your doctor immediately.

 

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Reference

Mayo Clinic. Trigger finger. Available at: https://www.mayoclinic.org/diseases-conditions/trigger-finger/symptoms-causes/syc-20365100

 

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