Cambridge Plastic Surgery

Plastic and reconstructive surgery, hand surgery and aesthetic surgery


Trigger finger

Trigger finger can present with stiffness, catching, and potentially locking of the finger in a flexed posture.

Normal flexion and extension of the fingers requires efficient movement of the flexor tendon with the flexor tendon sheath. This is strong tube-like structure holds the flexor tendons in close approximation to the bones within the fingers. The lining of the flexor tendon sheath is smooth: any disruption of this surface results in a loss of the normal efficient gliding of the flexor tendon.

Trigger finger is probably caused by inflammation and swelling of the soft tissues that coat the flexor tendons, combined with localized wear and tear in the flexor tendon sheath. In trigger finger the flexor tendon catches on the edge of the flexor tendon sheath, this can cause pain, stiffness, and locking.

Making the diagnosis

The diagnosis can usually be made in clinic. Patients will often have very localized tenderness over the base of the finger.

Most patients will respond to an injection of steroid into the flexor tendon sheath, administered in clinic. If the injection fails, or if the condition recurs, surgery is effective.

The operation

Surgery is performed under local anaesthetic, as a day case procedure. Patients taking aspirin, do not need to stop their medication. Patients taking warfarin need to achieve an Internal Normalized Ratio (INR) of below 2.5.

A transverse incision

Local anaesthetic injection

Wound closure

Patients cannot drive home after surgery, but can usually resume near normal activity within 1 week. There is a small risk of stiffness, swelling, scar tenderness and recurrence.

Risks

Risks include infection, lingering stiffness, and swelling.

More information
Patients can find more information on the BSSH website: www.bssh.ac.uk/patients/conditions/18/trigger_fingerthumb

To make an appointment
please call 01223 550 881 or email: igrant@uk-consultants.co.uk

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