Trigger Finger

Trigger finger surgery in Montreal

Trigger fingers can cause significant distress. At Station L, our board certified plastic surgeons specialize in treating such conditions in a safe and efficient manner.

What is trigger finger?

Trigger finger, also called “Stenosing Tenosynovitis”

 

Trigger finger is a condition that causes your finger or thumb to get stuck in a bent position, in addition to causing pain and stiffness. In cases where the thumb is affected, it’s called a trigger thumb. The condition makes bending and straightening your fingers difficult as it limits your finger’s movement.

The first indication of the condition may be slight stiffness or even “clicking” when flexing the finger/thumb especially in the morning. This is often associated with some discomfort. If it progresses, one may need to use your other hand to bend or straighten the finger. When the finger does move, a snap or click may be felt, as it suddenly gets “unstuck”. This is the triggering that gives the condition its name. It can get to thestage where every time you flex the finger in locks into position and has to be forcibly straightened.

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    How does the Trigger finger problem develop?

     On the front of each finger is a series of pulleys forming the flexor tendon sheath that provides a smooth tunnel which allows the tendons to glide through and flex the finger.

     Trigger finger occurs when the pulley at the base of the finger (A1 pulley) becomes thickened and constricting around the tendon, making it difficult for the tendon to move freely through the pulley. Sometimes the tendon develops a nodule or swelling of its lining. Due to the increased resistance to the gliding of the tendon through the pulley, one may feel pain, popping, or a catching feeling in the finger or thumb.When the tendon catches, it produces inflammation and more swelling. This causes a vicious cycle of triggering, inflammation, and swelling. Sometimes the finger becomes stuck or locked, and is hard to straighten or bend.

     

    Signs and Symptoms

    Commonly reported symptoms associated with trigger finger include the following:

     

    • Pain and tenderness over inflamed tendon nodule
    • Bent finger suddenly pops out and straightens
    • “Popping” or “clicking” sound or sensation when the nodule moves through the pulley
    • Finger feels stiff and sore
    • Finger get locked with inability to straighten when the nodule grows large and gets stuck in the pulley
    • Symptoms are worse in morning
    • Long-term complications of untreated trigger finger can include permanent digit swelling and contracture, as well as tearing of the tendon or rupture

    What causes trigger finger?

    Trigger finger is caused by inflammation of the tenosynovium. Inflammation forms a nodule and makes it difficult for the tendon to glide smoothly within its sheath causing “catching” of the finger in a bent position and then suddenly releasing the finger straight.

    Other causes of trigger finger can include the following:

    Repetitive Motion: Individuals who perform heavy, repetitive hand and wrist movements with prolonged gripping at work or play are believed to be at high risk for developing trigger finger.

    Medical Conditions: Conditions associated with developing trigger finger include hypothyroidism, rheumatoid arthritis, diabetes, and certain infections such as Tuberculosis.

     

    How is it diagnosed?

    Trigger finger may start with discomfort felt at the base of the finger or thumb, where they join the palm. This area is often tender to local pressure.

    A nodule may sometimes be found in this area. When the finger begins to trigger or lock, the patient may think the problem is at the middle knuckle of the finger or the tip knuckle of the thumb, since the tendon that is sticking is the one that moves these joints. An X-rays and other tests generally are not needed unless multiple fingers are triggering.

     

    Possible risks associated with Trigger finger?

    As with any surgical procedure, some potential risks can occur with trigger finger surgery. These include infection, stiffness of the finger, scarring and nerve damage. Tendon bowstringing after trigger finger surgery can also occur in very rare cases, where the finger is prevented from extending fully and must be corrected by further surgery. During your initial consultation, your surgeon will talk you through the potential risks of trigger finger surgery and make sure you are completely aware of what may happen, however unlikely the complications may be.

     

    Treatment

    Depending on the severity of the condition, the condition may be treated with nonsurgical methods including anti-inflammatory medications or local injections of a steroid into the joint. Splinting the affected finger or “buddy taping” it to the finger directly next to it can allow the finger to rest and heal.

    If the condition is unable to be successfully treated with nonsurgical methods and is affecting the patient’s quality of life, surgical treatments may be needed. Surgical treatment is usually an outpatient procedure that uses only local anesthetic and may be done either in the doctor’s office or in an operating room. Surgery will focus on removing or breaking up the constricting material that is causing the tendon to catch and lock in place.

     Steroid Injection
    This is especially helpful in recent onset triggering. An injection of steroid into the area around the tendon and pulley can be effective in relieving the trigger finger/thumb. This should not be performed more than twice as it can damage the tendon.

    Surgical
    If non-surgical forms of treatment do not relieve the symptoms, surgery may be recommended. This surgery is performed as a day only procedure, and occasionally under local anaesthetic only. This Involves making a small incision in the palm and incising the tight A1 pulley so that the tendon can glide more freely.

     

    What to expect for Trigger finger recovery

    It is our goal at Station L to ensure that your entire experience from the initial consultation to your recovery is as positive and comfortable as possible. Your plastic surgeon and surgical coordinator will go over your post-operative instructions and recovery with you as it is essential for your Trigger finger results that you follow care instructions closely.

    After trigger finger surgery, you might experience minor swelling and soreness for several days. You might also have difficulty moving the finger initially, but this will improve in a few weeks. You might experience slight numbness or tingling near the incision site — this sensation will improve over time as well. After about a week, you will come in for a post-op appointment, at which point the doctor will remove your sutures and dressing.

    First 24 hours: Have someone in place to pick you up from your surgery and care for you at home

    Back to work: You might be able to return to work within a few days if your job doesn’t require repetitive use of the affected hand but if you’re required to do any heavy lifting, have to apply pressure to the hand, or perform repetitive movements, you might need up to six weeks off work.

    Final results: Total healing time is about six weeks, after which most patients can resume regular activity.

    Part of our process at Station L is making sure that you have all the information you need to make informed decisions and feel guided through the entire process. Our concept is for you to have a five star experience, and our goal is for you to have the best possible outcomes and least possible complications.

     

    At-Home Care

    After surgery, take the following steps to ensure a smooth healing process:

    • Get plenty of rest. If you’re feeling tired, that’s a sign your body needs rest to recover.
    • Stay active. Start with a low-impact exercise, such as walking, each day.
    • Rest the hand. Avoid using your hand for lifting, typing, washing, vacuuming, or other repetitive movements.
    • Resume activities. You can shower, but avoid taking baths until the doctor removes your bandage and sutures.
    • Eat a balanced diet. If you’re experiencing nausea, you might try a bland diet for the first few days after your procedure.
    • Continue with medications. If you’re on blood thinners or take Aspirin, ask when it’s safe to resume them after your surgery.
    • Keep it covered. Leave your bandage on until you’re instructed to remove it. Keep the area clean and dry.
    • Ease into movement. You can bend and straighten your fingers gently a few times throughout the day to help reduce swelling and keep them flexible. You might need physical therapy to regain full range of motion and strength in your hand. Once you’re fully recovered, you’ll still want to take preventative measures when exercising to keep from reinjuring yourself.

    Proper follow-up care is key for a successful recovery. Be sure to go to all your follow-up appointments as directed and call the office if you have any issues or questions.

     

    Our office is always available for questions via email or text message should more questions arise.

    Choosing Your Surgeon

    We at Station L know that electing to have plastic surgery is a big decision. Finding the perfect plastic surgeon to fit your needs, your desired results, as well as your personality can be overwhelming. This is why we provide multiple surgeons to choose from, in hopes that you will find the right fit in one convenient, central location. Knowing that you are comfortable and feel at ease with your choice is our way of helping you have a five star experience.

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