Trigger finger surgery

For those suffering from trigger finger, the clever name doesn’t really express the pain they go through on a daily basis. The finger or thumb stiffness and unpredictable movements of trigger finger can make many daily tasks awkward or painful–or even impossible.

When the thumb or fingers get stuck in a curled position, or shoot out unreliably and suddenly into a straight position, affected individuals may drop things. They may have trouble picking things up quickly and may be unable to grasp and carry things us at all. In some cases, the trigger finger may become locked into the curled position and unable to straighten.

Besides the pain and disability of not being able to move the hand properly, trigger finger may cause embarrassment or nervousness and may erode confidence. When non-surgical treatments have not helped to relieve the symptoms of trigger finger, a NJ plastic surgeon specializing in hand surgery can help.

What is Trigger Finger?

Trigger finger is a tendon condition affecting the fingers or thumb, making it difficult to straighten the digits. Trigger finger (TF) causes affected individuals inconvenience, anxiety and often, significant hand pain.

The condition limits the free and smooth movement of the finger joints and/or the thumb, causing joints to catch, and sometimes suddenly pop out straight. Alternatively, fingers may get stuck permanently in a bent or curled position.

Although it has a lighthearted name, trigger finger is a serious and often painful condition for many Bergen County residents.

How do Tendons Normally Function in the Hand and Fingers?

Tendons are found in all of the joints of the human body, connecting muscles and bone and allowing us to move our limbs and trunk. Tendons in the hand allow the bending of fingers and the thumb to pick up objects, write, use a keyboard and many more essential everyday activities.

In order to move the fingers and thumb, long flexor tendons glide through a sheath made of ligaments and lubricating tissue. Ligaments hold the sheath and tendons in place next to the bones they control.

Flexor tendons run from the forearm muscles through the wrist, connecting to the small finger and thumb bones, allowing them to flex and bend as the muscles move. A NJ trigger finger surgeon can help patients regain this normal function.

What Causes Trigger Finger or Trigger Thumb?

The jerking finger movements or stubbornly curled fingers of trigger finger happen when the tendon has trouble moving freely through its protective sheath.

  • The tendon sheath/ligaments or the tendon itself becomes irritated and swollen and may develop nodules. This crowds the area and impedes the tendon’s movement through the tunnel-like sheath. The tendons/nodules can become stuck under a ligament (pulley) when moving through the now-crowded space. As a result, the fingers move slowly or jerkily.
  • Trigger fingers may develop after overworking the hand on the job or when moving house or doing other strenuous, hand and finger-intensive activities. Smokers may get trigger finger from flicking cigarette lighters with their thumb repeatedly, over time.
  • Diabetes, gout and RA (rheumatoid arthritis) can make people more susceptible to trigger finger.
  • Women are affected more often than men and the problem typically begins in middle age, between 40 and 60.

Symptoms That Bring Trigger Finger Suffers to the NJ Hand Surgeon

Symptoms of trigger finger usually start without any injury, although they may follow a period of heavy hand use.

Symptoms may include:

  • A painful lump in the palm of the hand.
  • Pain and tenderness at the base of the finger or thumb.
  • Swelling in the fingers, thumbs and hand.
  • Finger stiffness.
  • Pain when straightening and flexing finger(s).
  • A hesitation, “hitch” or clicking and popping feeling when moving the thumb and/or finger joints, especially the knuckles. Fingers may remain curled–or suddenly straighten out in an unpredictable way.
  • Symptoms may be worse after resting or sleeping and may fade as movement loosens up the fingers.
  • Complete inability to straighten the finger may result. The finger may become locked in place, curled tightly toward the palm. The patient may be able to straighten the finger using the other hand to pull it straight again. Sometimes the finger remains locked and curled.

Good Candidates for Trigger Finger Surgery

Hand surgery for trigger finger helps to prevent permanent finger stiffness. Patients who can benefit from trigger finger treatment by a NJ hand surgery specialist are:

  • Individuals who have not been helped (or helped only temporarily) by non-surgical options, including:
    • Over-the-counter anti-inflammatory pain medications like NSAIDs.
    • Resting.
    • Splinting of the fingers and hand.
    • Corticosteroid injections.
  • Patients with restricted hand/finger movement that is bothersome or disabling.
  • People looking for relief from painful fingers, thumbs, hands and even forearm pain.
  • Patients who find daily tasks have become impossible, awkward or painful.
  • Patients who feel the condition is getting worse over time. Affected individuals may drop things and have trouble picking items up quickly or may be unable to grasp and carry things at all.
  • People who find trigger finger embarrassing or nerve-racking. The condition can erode confidence.
  • Individuals whose trigger finger may interfere with work or ability to enjoy leisure activities.

How is Hand Surgery for Trigger Finger Performed?

This is an outpatient procedure typically performed under local anesthesia to numb the hand and fingers. A Bergen County plastic surgeon will make a small scalpel incision or use a needle to release (cut into) the tendon sheath of the affected finger(s) or thumb. This releases the pulley (ligament) so that the tendon will no longer get stuck.

A skilled NJ plastic surgeon will place the incision so that it is hidden in one of the creases of the hand. Once healed, the sheath becomes larger providing more space (a larger tunnel) for the tendon to move through, allowing the finger to move freely and smoothly once again.

Risks of Trigger Finger Hand Surgery

Complications include infection, bleeding and risks common to all surgical procedures, but are exceptionally rare in this type of hand surgery. Depending upon the patient’s overall health and case details, specific additional risks may apply, which the Northern NJ hand specialist will explain before the procedure is scheduled.

Continued snapping of the joint or inability to straighten the finger can occur if the release of the tendon sheath was insufficient or overly aggressive. Many complications can be avoided or minimized by choosing a specialized hand surgeon with microsurgery experience and board certification in plastic surgery.

Recovery from Hand Surgery for Trigger Finger

Recovery and healing after surgical release of trigger finger usually takes just a few weeks. As soon as the local anesthesia wears off, patients can move their fingers. Some inflammation and stiffness may persist for up to 3-6 months.

The palm will be sore, gradually improving over the recovery period. Swelling and pain can be reduced by propping the hand above the level of the heart. Finger exercises may be prescribed to loosen stiffness during recovery.

Choose the Best Hand Surgeon for Trigger Finger

Dr. Janet Yueh at Cohen/Winters Aesthetic & Reconstructive Surgery in Bergen County, NJ,  specializes in minimally traumatic and effective hand surgery for Trigger Finger. Contact us to learn how you can escape the effects of trigger finger and regain pain-free movement with this outpatient hand surgery procedure.

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