14-Mar-07 8:00 AM CST

Trigger Finger

Stenosing Tenosynovitis (Trigger Finger)
   If you wake up in the morning and your thumb or finger is “locked” in a flexed position, you may have a trigger finger. Trigger finger or (Stenosing Tenosynovitis) is inflammation around the tendons to your fingers or thumb.
   Tendons (cordlike fibers that attach muscle to bone and allow you to bend your fingers) are held in place on the bones by a series of ligaments called pulleys. These pulleys form a series of arches through which the tendons run along the bone. To keep tendons moving smoothly through these pulleys, the tendons are wrapped in a slick membrane called tenosynovium.
   Irritation to the tendon or the tenosynovium may cause a nodule to form, which makes it difficult for the tendon to slide through the pulley. When the tendon catches and then suddenly releases, you feel a “triggering” sensation.
   The cause of a trigger finger is not always clear. Anything that irritates the tendons in the finger, such as repeated use of tools, rheumatoid arthritis, gout, or diabetes can lead to the development of trigger finger. When you have a trigger finger, you will feel discomfort or pain where the finger or thumb joins the palm. You may have swelling or thickening at the base of the finger or thumb. A clicking sensation is often felt when the finger is bent. The finger may lock in a bent or straight position.
   Your doctor can tell from examining your finger or thumb whether a tendon is inflamed and triggering is occurring.

    The treatment for a trigger finger is aimed at decreasing the inflammation around the tendon and tendon sheath.
This includes:
• Resting the finger or thumb. Sometimes a splint is used
• Taking oral anti-inflammatory medication.
• A small injection of cortisone into the area of inflammation.

     If other treatments do not relieve your symptoms then a trigger finger release may be performed to open the pulleyand allow thetendon to glide smoothly again.
    This is an outpatient surgery. Normal use of the hand can be resumed once comfort permits. Occasionally, hand therapy is indicated after surgery to help you regain your motion and strength.