2340 Apple FEB MARCH 2016 MkII FINAL PROOF2

TRIGGER
FINGER
By Professor Abhilash Jain
MBBS, MRCS, MSc, PhD, FRCS(Plast)
Associate Professor of Plastic and Hand Surgery,
University of Oxford & Imperial College Trust London
Trigger finger is a common condition
affecting the base of the finger or
thumb in the palm, particularly when
trying to straighten the digit.
It can produce a “click” when the digit is straightened. Tendons
pass through a tunnel in the finger, known as the flexor sheath.
Sometimes this becomes swollen and restricts tendons, causing
them to ‘catch’ and ‘lock’. This catching can cause pain and
restrict movement which results in ‘triggering’.
Trigger finger is more common in women, patients over 60, in
the dominant hand and in those with diabetes or arthritis. It is
also associated with other conditions such as carpal tunnel
syndrome, which is caused by compression of the median
nerve and can cause tingling and numbness in the fingers.
Once the finger starts to lock, it is likely to get worse unless
treated. Within the first six months, prevention of movement
of the finger using a splint for up to six weeks can be effective,
however it can result in some stiffness.
Instead, most specialist Hand Surgeons treat trigger finger with
a steroid injection. This is usually effective and patients can use
the hand immediately, although the triggering may take a
couple of weeks to settle down. Sometimes a repeat injection
is needed six weeks following the first injection.
In severe cases, a small operation may be necessary. This simple
surgery only requires a local anaesthetic, but must be carried
out by a specialist Hand Surgeon – and JDoc365 can refer you.
The procedure is almost 100% successful, is not usually painful
and patients are able to use the hand normally almost
immediately.
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