Trigger finger or spring finger is a mechanical problem with the fingers that sometimes requires the intervention of a hand surgeon. This impairment manifests itself mainly by difficulty, or even blockage, when flexing one or more fingers of the hand. Disabling, trigger finger could be associated with a release of the carpal tunnel in certain people, according to The National Library of Medicine.
What are the symptoms of trigger finger?
A person tries to close his hand. She bends all her fingers. One of them doesn’t close as well as the others. It closes partially, or does not flex at all. For which motive ? Perhaps because a tendon responsible for flexing the finger has become stuck against a phalanx. This mechanical problem is the main characteristic of the trigger finger. This hand condition can affect one or more flexor tendons of any finger of the hand. The discomfort caused by the blockage appears in the palm of the hand. The discomfort can become painful if left untreated. The blockage is especially visible in the morning, upon waking up. It may be accompanied by joint stiffness and swelling of the hand. Sometimes the blocked tendon suddenly releases. It behaves like a rope in a pulley. The movement of flexion or extension of the hand then becomes fluid and complete again.
What causes spring finger?
Spring finger results from inflammation of the flexor tendon. A nodule forms, complicating the passage of the tendon through the pulleys of the flexor apparatus. Trigger finger can be caused by repetitive movements, for example: on a cutting line, in meat processing companies or when trimming hedges at gardeners. This damage to the hand flexor tendons is associated with several risk factors, including:
In infants, trigger finger is due to a congenital malformation.
How to diagnose trigger finger?
Clinical observation allows the doctor to suspect a case of spring finger. He asks the patient to make an extension movement with the hand. A jump occurs and the extension unlocks. This observation is generally sufficient to confirm the diagnosis. Medical imaging tests are not really helpful in making a diagnosis. The x-rays reveal nothing special. An ultrasound may reveal an effusion of fluid inside the digital sheath.
Treatment of trigger finger
In the event of slight damage, the hand must be rested, especially if the problem is caused by repetitive gestures. If the blockage persists and worsens, local infiltration may be indicated. A corticosteroid is injected directly into the tendon. The injection may cause pain lasting up to 48 hours. For this local treatment to be effective, the hand surgeon performs a second infiltration, a few weeks or months after the first. When the damage is severe, surgery is necessary to unblock the flexor tendon. The procedure takes place on an outpatient basis, under regional anesthesia. It is not painful. The release of the tendon from the flexor apparatus through surgery has a name: tenolysis. The surgeon opens the digital sheath. It lifts the tendon stuck against the bone to free it. It is sometimes necessary to also open the joint: this is called teno-arthrolysis.
The scars are impressive because they are very visible. They follow the zigzag shape of the incision. Rest is almost always sufficient for complete recovery. It takes about three weeks to regain normal mobility, with the flexor tendon sliding normally. Splinting and rehabilitation are not necessary. Anti-inflammatories are indicated to prevent pain and inflammation. After three weeks, the patient can resume their manual activities normally and smoothly. However, you have to wait a few months to gain muscle strength.
Sources
- Trigger fingerFrench Institute of Hand Surgery
- Trigger fingerSouth Aquitaine Institute of the Hand and Upper Limb
- Trigger finger: what is it?Monegasque Institute of Sports Medicine and Surgery, May 8, 2020
- Relationship of Carpal Tunnel Release and New Onset Trigger FingerNational Library of Medicine, National Institutes of Health, November 6, 2018
Read also :
⋙ Achilles tendon pain: how to recognize it and what are the possible causes?
⋙ Tenosynovitis: advice from the rheumatologist to recover quickly
⋙ Pain behind the knee: what are the possible causes?