Transcript TRIGGER FINGER

TRIGGER FINGER
What is trigger finger?
 Trigger finger is a common hand condition characterized
by pain and catching when bending a finger to make a
fist.
 There are structures called pulleys that form a smooth
tunnel for the tendons to pass through as you move your
fingers.
 A trigger finger develops when these structures become
inflamed and thickened, causing the tendon to catch on
the opening of the tunnel and form a nodule within itself.
This is the mechanical triggering you feel as the tendon
becomes “unstuck”.
Trigger finger anatomy
Normal
Trigger finger
Treatment options
 CORTISONE INJECTIONS
 Cortisone injections are often given
to help reduce inflammation in and
around tendons and joints.
 This medication is injected with a
local anesthetic. This will provide
pain relief from the injection for a
few hours following. It is common to
have increased soreness for a few
days after the injection.
 Onset of the medication may take
up to a week before you begin
noticing improvement. Symptom
relief is variable, but averages from
1-3 months.
 Diabetics should use cortisone with
caution, as it can increase blood
sugar levels.
Surgical treatment
 TRIGGGER FINGER RELEASE
 Surgical treatment for this problem involves releasing the
inflamed and thickened pulley in the offending finger.
 This is an outpatient procedure performed under local
anesthesia. We are able to give you some sedative
medication through an IV to keep you comfortable.
 The procedure takes about 15-20 minutes to perform.
Thickened pulley
Risks
 Anesthetic
 Infection
 Numbness
 Recurrence
Post-operative care
 A soft dressing is applied after
surgery. You will be able to use
your hands for light activity later
that day.
 Keep the surgical dressing and
incision clean and dry. After 48
hours you may remove the soft
dressing and your incision may
get wet in the shower, but no
soaking. Apply a band-aid to
keep the incision clean if
necessary.
 Approximately 10-14 days postoperatively you will return to Dr.
Foad’s office for a follow-up visit
and suture removal.
TRIGGER FINGER
POST-SURGICAL FAQ’S
When do I see Dr. Foad after surgery?
You will return to see Dr. Foad for your post-op visit about
10-14 days after surgery.
When do the stitches come out?
Stitches will be removed at your post-op visit 10-14 days
after surgery.
When can I use my hand?
You will be able to begin using your hands for light
activities usually the night of surgery. You will have a soft
bandage on the hand that leaves your fingers and wrist free
to move. You can perform simple functions such as
feeding yourself, brushing your teeth, carrying a cup of
coffee, etc. and continue to increase those as tolerated.
What if my pain medication causes itching
Are there any exercises that I should do?
It is important to maintain motion of the finger that you just
had surgery on to prevent scarring around the tendons that
were released during the procedure. The best way to do
this is to make a tight fist with all of your fingers, then
straighten the fingers out making sure that all of the joints
get as straight as you can make them. You should do this
for 5-10 repetitions, 1-2 times an hour if possible. Please do
your best to flex them into a fist, and then make sure to
straighten them with each repetition. Maintain these
exercises until you have regained more comfortable use of
the hand or until your follow up visit.
Why is my finger numb?
The local anesthetic that is used during the procedure often
leaves the operative finger(s) and adjacent fingers numb for
many hours. This may last well into the night of your
surgery. The numbness from the anesthetic usually wears
off by the following morning, but it may last a little longer.
How do I care for my dressings?
You will have a soft bandage (not containing any hard cast
material) after surgery. This should not get wet. You will
be able to remove this on your own 48 hours after surgery.
At that time you can cover the incision site with a band aid
to keep it clean.
When may I shower or bathe?
You may begin to shower or bathe as soon as you like. If
the original surgical dressing is still on, take care not to get
it wet. After 48 hours, please remove your soft dressing.
You may wash your incision in the shower, however, do
not submerge the incision underwater for an extended
period of time, such as in a pool or hot tub.
or nausea?
It is not uncommon for pain medications to cause these two
side effects. If you experience itching you may take
Claritin or Benadryl to help with this. If you are
experiencing nausea, a prescription for Phenergan (aka
promethazine) was given for this purpose on the day of
your procedure. Remember to take your pain medication
with food to diminish the potential for nausea.
What about swelling?
Swelling is quite common following these procedures. Do
your best to keep the hand elevated above the level of your
heart. Moving the fingers to open and close into a tight fist
is also encouraged. Taking ibuprofen (Advil, Motrin) in
addition to your pain medication will help with swelling
(note: do NOT take more acetaminophen/Tylenol as it is
already a component in the prescriptions you were given)
When may I drive?
You may begin driving again when you feel comfortable
behind the wheel AND you are no longer taking any of the
narcotic pain medications. If you would feel comfortable
driving next to yourself on the road, it is probably safe for
you return to this activity.
When can I go back to work?
It depends on the type of work you do. Those with jobs
that are more sedentary and do not require heavy loads are
often able to start returning to their duties within 1-2
weeks. Jobs that involve extensive heaving lifting and
strain on the hands may take 3-4 weeks before they are able
to return to work functions more normally. This is
something quite unique to every patient’s situation and can
be discussed more specifically with Dr. Foad at your office
visit.