Hand Surgery
Trigger Finger Repair
Tendons are the structures responsible for the relationship between muscles and bones, transmitting the contraction force of muscles to bones and joints.
About Trigger Finger
What is Trigger Finger Repair?
Tendons are the structures responsible for the relationship between muscles and bones, transmitting the contraction force of muscles to bones and joints. In the case of the fingers, the contraction force of the forearm muscles responsible for finger movements is transmitted to the fingers by the tendons in between. As tendons travel from the forearm and extend to the fingers, they pass through certain pulley systems and sheaths (tunnels) so that they can advance in the palm without their relationship with the bones being disturbed. Each tendon moves by gliding within the sheath covering it. Conditions in which the mechanics of movement are disturbed as a result of tendons becoming caught while passing through these pulley systems are called trigger finger disease.
Patients with trigger finger complain that when they open their fingers after making a fist, one or several of the fingers catch at first and do not open, and after a short time snap open on their own with a click. This condition is generally encountered in people over 40 years of age and in those with diabetes or rheumatic disease. However, it can be seen at any age, even in newborns. At young ages it can be seen in athletes who use their palms a lot (such as off-road cyclists and motorcyclists, and mountaineers).
The mechanism by which trigger finger develops is still not fully known, but the course of the disease is very well known. Because the tendon sheath swells and thickens due to inflammation, the tendon encounters difficulty in the gliding movement it must perform during finger movements. At first the symptoms take the form of catching due to reduced movement in the damaged part of the sheath, relieved only with a jumping movement; if no treatment is applied and the condition progresses, it ends with the sheath gradually thickening and tendon movement being lost completely, with the finger remaining locked in a trigger-pulling position.
The aim of treatment is to ease the movement of the tendons and prevent catching. The main treatment of trigger finger is surgery. However, in the early stages conservative treatments can be used to buy time before surgery. In sudden and newly started cases (starting within a period of less than 3 weeks), aspirin or similar drug treatment aimed at reducing the swelling in the tendon and tendon sheath, and finger splints for rest, can be tried. If the complaints do not regress, a local steroid (cortisone) injection will be given into the thickened area of the tendon. The relief provided by this treatment varies from patient to patient, lasting from a few weeks to a few months. Recurrence is frequent. This treatment can provide complete recovery in subacute cases (in which complaints such as pain and morning stiffness began within 3 weeks to 3 months (locking may begin much later)).
In people in whom this condition has developed due to diabetes or rheumatic disease, in chronic cases (with complaints for more than three months) and in cases with frequent locking, the treatment is surgery. In trigger finger surgery, the area where the trapped tendon is compressed is released. Effective results are obtained with the operations. After the operation, movement will return to normal immediately. Physical therapy and rehabilitation may be needed after the operation.
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