RIFREQUENTLY ASKED QUESTIONS
Q. Fasting before Operation?
A. Nothing to eat or drink at least 6 hours before the operation.
Q. Anaesthetic?
A. General, arm block or local anaesthetic can be used.
Q. Duration of Operation?
A. About 30 minutes.
Q. Pain?
A. Pain from the operation is usually very mild and easily settled with simple analgesia such as paracetamol.
Q. Will I be in a plaster after the operation?
A. No. The wound should remain dry and covered until the stitches are removed.
Q. Will I need physiotherapy after the surgery?
A. Usually just your own movements will be enough to regain normal movement. If recovery is slow, hand therapy treatment may be recommended.
WHAT IS IT?
Stenosing tenosynovitis, commonly known as trigger finger or trigger thumb involves the pulleys and tendons in the hand that bend the fingers.
The tendons work like long ropes going from the muscles of the forearm and passing through a tunnel of tissue and bone into the hand to reach the fingers and thumb. The tendons in the tunnel have a slick lining, which allows easy gliding like a pulley.
Trigger finger or thumb happens when the tendon develops a nodule or swelling of its lining. When the tendon swells, it must squeeze through the opening of the tunnel (flexor sheath), which causes pain, popping, or a catching feeling in the finger or thumb.
When the tendon catches, it pro¬duces inflammation and more swelling. This causes a vicious cycle of triggering, inflammation, and swelling. Sometimes the finger becomes stuck (locked) and is hard to straighten or bend.
WHAT CAUSES IT?
Causes for this condition are not always clear. An injury to the palm may irritate the flexor tendons. The medical conditions rheuma¬toid arthritis, gout and diabetes are associated with trigger finger or thumb symptoms.
HOW DOES IT PRESENT?
Trigger finger or thumb may start with discomfort felt at the base of the finger or thumb. A thickening may be found in this area. When the finger begins to trigger or lock, the pro¬blem may seem to be in the middle knuckle of the finger or the end knuckle of the thumb.
TREATMENT
The goal of treatment in trigger fin¬ger or thumb is to eliminate the catching or locking and allow full movement of the finger or thumb without discomfort. Swelling around the flexor tendon and tendon sheath must be reduced to allow smooth gliding of the tendon.
The wearing of a splint or taking anti-inflammatory medication by mouth or by cortisone injection into the area around the tendon may be recommended to reduce swelling and relieve the catching. Treatment may also include changing activities to reduce impact.
SURGERY
If non-surgical forms of treatment do not improve the symptoms, surgery may be recommended. This surgery is performed on an outpatient basis. Anaes¬thesia may be local, general, or regional (where only the arm is numbed).
The aim of the surgery is to release the pulley that is blocking normal tendon movement, and inspect the tendons for any sign of damage.
Some patients may feel tenderness, discomfort, and swelling about the area of their surgery a little longer than others.
Active motion of the finger generally begins immediately after surgery. Normal use of the hand can usually be resumed once comfort permits.
