Hand Surgery

Trigger Finger / Thumb

Symptoms

Trigger finger diagramTrigger finger (of thumb) is where a finger repeatedly clicks or gets stuck and this is usually painful. This problem may occur after doing a repetitive or heavy activity with the hand, or may occur without any obvious cause. Trigger finger is more common in people with diabetes.

Trigger finger initially may be only a minor inconvenience but can progress to a locked finger, where it is not possible to straighten (or sometimes to bend) the finger. You may be able to force the finger out straight, which is painful, and it will then tend to lock again.

Trigger finger is due to the tendon in the finger getting stuck as it passes under a tight ligament called a pulley. The pulley is at the base of the finger in the palm of the hand. The reason trigger finger develops in most cases is due to inflammation (irritation and swelling) of the tendon which then makes it too thick to smoothly glide through the pulley. Trigger finger occasionally resolves without treatment but when this does occur it is usually very slow.

Treatment

A steroid injection is the best treatment for mild cases and those of short duration. A minor surgical procedure is advised for more severe cases of trigger finger and for locked fingers. The surgical procedure is called trigger finger release. This minor operation is usually done with local anaesthetic injection (you are awake throughout). The procedure takes about 15 minutes to do and you are able to go home immediately afterwards. 2 or 3 stitches are used and these are removed 10 days after the operation. A small 'band aid' type dressing is applied and I encourage patients to start using the hand for light exercises immediately.

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