Trigger Finger

01.04.2020

Definition

In the hand, the finger flexor tendons (superficial and deep flexor tendons) pass through a tunnel system (= tendon sheath), which is reinforced at defined points. These reinforcements are called pulleys and they serve to hold the tendon on the bone to avoid lifting of the tendon which would lead to a loss of strength when bending the fingers. If the tendon sheath is narrowed or the tendons thicken, the gliding ability of the tendons is impaired. The result is that the tendon gets pinched at the level of the first ring band (tunnel entrance) and the active extension of the finger is associated with a snap phenomenon. In extreme cases, the finger is fixed in the palm of your hand when you bend it. The causes of the narrowing can be repeated overloading (too much weight) during unusual activities, but also chronic inflammatory diseases such as rheumatism or gout. But other diseases such as diabetes mellitus can also be associated with an increase in the tendon sheath tissue.

Symptoms

Initially, one experiences pain at the base of the fingers or at the base of the thumb or snapping of the fingers in the morning after getting up. With time, also snapping of the fingers after each fist closure. In extreme cases, the finger gets caught in the palm of the hand.

Examination

A clinical examination; usually no further diagnostics are required.

Operation

Hand block, incision across the base of the thumb or diagonally in the palm, keeping arteries and nerves aside, longitudinal folds of the ring band, which will heal in expanded position. Suture, bandage with an elastic bandage.

Follow-up Treatment

Move the finger immediately, use your hand for everything possible, but keep the wound clean and dry. Stitches are removed 12-14 days after the operation.

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