ORTHOPEDICS/HAND & WRIST/FINGER DISORDERS
When the tendons of a finger are caught as the finger curves and straightens, trigger finger, which is a common tendon difficulty, may happen causing the digit to a sudden opening, or even to stay curved into the palm of the hand.
Trigger finger is very common with diabetic patients.
While many people can find relief with non-surgical therapy for trigger finger, some other will need to have a medical surgery to resolve this disorder.
Trigger finger is caused when the tendon becomes caught as it passes through a pulley in the palm of the hand.
The Tendons pull your fingers into a fist when your forearm muscles are contracting. Normally the tendon is attached to the bones of the fingers by multiple cranes. These cranes keep the tendons against the bone, but one particular crane (called the A1 crane) can thicken resulting the tendon to becoming stuck.
There are two main alternatives to consider when performing a trigger finger surgery: open surgical release and percutaneous release.
- Open Surgical Release
An open surgical release is the standard surgical therapy for a trigger finger.
During this surgery, a small incision (one centimeter) is opened over the palm of the hand where the tendon is being stuck.
Most surgeon recommends local anesthetic.
With local anesthetic, the patient can bend the finger once the release has been performed to ensure that the problem is solved.
A junction or two, or sometimes a skin glue are used to close the incision after an open surgical release.
Most specialists enhance immediate fingers motion, but with restricted pressure on the incision. Triggering is being immediately resolved.
Sometimes, patients do have some uneasiness around the incision, and frequently at the PIP joint (the second knuckle joint). In addition, some patients may notify finger painfulness that can take weeks or even longer to completely being resolved.
Studies and experiences have noted that complications of a trigger finger release are very rare, but may occur.
And as said before, there are uncommon reasons of a trigger finger, but if undefined and kept without therapy, can conduct to a permanent triggering state.
Inflammation is another eventual complication that may need therapy including the possibility of needing further surgery.
One complication that is more probable, also called tendon bowstringing occurs when the tendon pulls away from the bone after the crane is released.
Percutaneous Release
A percutaneous release is a less-aggressive surgical technique where a minimal incision is done and the crane is released straightforwardly.
This process have been shown to be effective and allows faster recovery.
To conclude:
Both alternatives seem to be effective therapy alternatives for a trigger finger.
Remember that the “gold standard” surgery is still the traditional open surgery, but still a little aggressive.
Recovery in all the above status is classically fast; however, percutaneous surgery still more advantageous since the incisions performed are smaller.
Finally and by all the means, surgeon’s experience still a most important factor.