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How do I treat trigger finger?
What is trigger finger surgery?
What is the recovery time?
How do I book my surgery?
Trigger Finger
What is Trigger Finger?
The tendons the hand have a sheath. This can sometimes become too narrow causing the finger to trigger.
In simpler terms, this is like a pair of pants that are too tight around your tendon. When those pair of pants are too tight, it stops the movement of your finger until it “pops” or “triggers”. Patients also have pain in the finger at the palm side of the knuckle.
For mild trigger finger, I often recommend to my patients decrease their activity or a steroid injection.
The steroid injection reduces inflammation of the tendon. I always recommend to try one injection first. The injection will have a local anesthetic, freezing like the dentist, and the steroid injection
Your finger will be numb for 4-6 hours after the injection. This is not the steroid medication. The steroid takes 3-4 weeks to work. For half of my patients, they will have their symptoms completely resolve forever. For the other half of my patients, a second injection is given 6-12 weeks after the first injection. 80% of my patients will have their trigger finger completely resolved.
20% of my patients will not have their trigger finger treated at this point. I recommend to have a surgery for these patients.
Some of my patients also will tell me after 3 weeks of their first injection, it made no difference. I also recommend surgery for these patients.
What are the risks of steroid injection?
Small risk of infection, nothing more than any other injection you have previous received (vaccines, IVs, etc)
There is a small chance your tendon can weak and rupture. This is very rare. This is also why I tell my patients not to have more than two injections per finger. It increases the risk of tendon ruptures
For patients whose fingers are locked and it is very difficult to open, I recommend to have a trigger finger surgery as well to offer a quicker solution
A small 1-2 cm incision is made on the palm and the tendon sheath is cut open to release the tendon. Dissolvable sutures are used to close the incision. I often do not have any follow-up scheduled with my patients, but if you have any issues please do not hesitate to call my office.
The benefits of the surgery:
The first benefit my patients will notice is that the finger will not longer trigger right after the surgery.
The second benefit is that the pain at the palm side of your knuckle will improve. This will only be noticeable after your have healed from your surgery as you will have expected post-operative pain for several days to weeks.
What are the risks of surgery?
All surgeries may cause infection, nerve injury, bleeding, or persistent pain
Infection ranges from 1-5%. Patients who have diabetes, use nicotine products, or have an autoimmune disease are at higher risks. If you use nicotine products please stop this 4 weeks before and after your surgery. A mild infection may have some increased pain or redness and can be treated with antibiotics. More severe infections may require the wound to be opened up again and long-term IV antibiotics.
Nerve injury to the nerve is always possible although very rare. If this happens, we will discuss this as this is a very serious complication. This may result in permanent numbness or weakness.
There is no significant bleeding from this procedure, but the wound can ooze blood. If this happens, please place firm pressure on the wound for 10 minutes and this should stop. If it does not, please call our office or present to your nearest emergency department for an assessment.
Persistent pain may continue after surgery either due to scar tissue or sensitive nerves after surgery. This often goes away, but can be quite distressing. I will continue to follow you closely until this improves.
Often times, trigger finger can occur in both your hands. I rarely do surgery on both hands at the same time because you would not be able to take care of yourself with bathing or other daily tasks for 2-4 weeks. I often ask my patients to completely heal from in one hand before doing the second surgery. This is often 6-12 weeks after the first surgery. More than one finger can be operated on at once as long as it is the same hand.
I ask most patients to take 4-6 weeks to recover before they are back to pre-surgery. Some patients may take longer due to scar tissue pain. I ask patients a minimum of two weeks to let the sutures heal if they cannot take four weeks off work. This is to let the sutures heal the wound. The sutures are strong, but not invincible!
You will be provide with a post-operative instruction sheet to guide you on healing. The dressing can come off after 3-5 days and washed with soap and water. The sutures will start dissolving between 2-4 weeks. After four weeks, if the wound has completely healed there are no restrictions.
I ask all my patients to not place their hands in any still bodies of water until the wound has healed - this includes bathtubs, jacuzzis, beaches, and no dishes for the next month. (I can write a prescription if your spouse does not believe you!) This is to prevent any infections.
Your family physician must send a referral to my office. Once we receive your referral we will book you in. We offer same day injections or surgery with your consultation if you would like this. Please ensure you have prepared to have adequate recovery time after the surgery (2-4 weeks off work with the operated hand).