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TRIGGER FINGER

TRIGGER FINGER

Trigger finger is a condition in which one of your fingers gets stuck in a bent position. Your finger may bend or straighten with a snap-like a trigger being pulled and released.

Trigger finger is also known as stenosing tenosynovitis. It occurs when inflammation narrows the space within the sheath that surrounds the tendon in the affected finger. If trigger finger is severe, your finger may become locked in a bent position.

People whose work or hobbies require repetitive gripping actions are at higher risk of developing trigger finger. The condition is also more common in women and in anyone with diabetes. Treatment of trigger finger varies depending on the severity.

HAND & WRIST ANATOMY

DISEASE EXPLAINED

SYMPTOMS

Finger stiffness, particularly in the morning.

A popping or clicking sensation as you move your finger.

Tenderness or a bump (nodule) in the palm at the base of the affected finger.

Finger catching or locking in a bent position, which suddenly pops straight.

Finger locked in a bent position, which you are unable to straighten.

CAUSES

Tendons are fibrous cords that attach muscle to bone. Each tendon is surrounded by a protective sheath. Trigger finger occurs when the affected finger's tendon sheath becomes irritated and inflamed. This interferes with the normal gliding motion of the tendon through the sheath.

Prolonged irritation of the tendon sheath can produce scarring, thickening and the formation of bumps (nodules) in the tendon that impede the tendon's motion even more.

TREATMENT

TREATMENT OPTIONS

Rest
Avoid activities that require repetitive gripping, repeated grasping or the prolonged use of vibrating hand-held machinery until your symptoms improve. If you can't avoid these activities altogether, padded gloves may offer some protection.

A splint
Your doctor may have you wear a splint at night to keep the affected finger in an extended position for up to six weeks. The splint helps rest the tendon.

Stretching exercises
Your doctor may also suggest gentle exercises to help maintain mobility in your finger.

Non-steroidal anti-inflammatory drugs
NSAID medications such as ibuprofen (Advil, Motrin IB) or naproxen (Aleve) — may relieve the pain but are unlikely to relieve the swelling constricting the tendon sheath or trapping the tendon.

Steroid injection
An injection of a steroid medication near or into the tendon sheath may reduce inflammation and allow the tendon to glide freely again. This is the most common treatment, and it's usually effective for a year or more in most people treated. But sometimes it takes more than one injection.

For people with diabetes, steroid injections tend to be less effective.

Percutaneous release
After numbing your palm, the surgeon inserts a sturdy needle into the tissue around your affected tendon. Moving the needle and your finger helps break apart the constriction that's blocking the smooth motion of the tendon.

This treatment may be done under ultrasound control, so the surgeon can see where the tip of the needle is under the skin to be sure it opens the tendon sheath without damaging the tendon or nearby nerves. This procedure is usually done in the doctor's office or in an office procedure room.

Surgery
Working through a small incision near the base of your affected finger, the surgeon can cut open the constricted section of tendon sheath. This procedure is usually done in an operating room.

CONTACTING DR. PERLMUTTER

Texting is preferred by Dr. Perlmutter for communication (717-836-6833). Please contact him ASAP, should you have any concerns whatsoever. Many patients fail to contact Dr. Perlmutter when they should have because they are "afraid of bothering him." This is a potentially dangerous attitude and Dr. Perlmutter will always welcome every opportunity to make his patients feel more comfortable. Please feel comfortable sending photographs to add perspective to your questions. Please turn on your flash, aim directly at the body part that you wish to show, and use an evenly colored, dark, and non-reflective background.

If you cannot text, you may call Dr. Perlmutter, however, you must use a confirmed caller ID unblocked telephone or he will not be able to return your call. If you need help turning off this feature you may:

1) Try pushing *82 prior to dialing, or

2) Use a different phone.

Your failure to do so will absolutely compromise your care and hurt your outcome!

If Dr. Perlmutter cannot be reached on his cell phone or by text, please contact the hospital operator to assist in reaching him or a member of his team. They can be reached at NASH: 252-962-8000. ECU Edgecombe: 252-641-7700.

IF YOU PERCEIVE AN EMERGENCY, PLEASE CALL 911 OR GO TO THE EMERGENCY ROOM ASAP.

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