TRIGGER FINGER

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Also known as stenosing tenosynovitis in medical literature, trigger finger is a pulley system disorder of finger flexor tendons functioning to bend the fingers of the hand and their bridges that they run under on certain points.

Tendons are like long strings that start from muscles of forearm and continue to the fingers, while pulleys are structures that tendons pass under at certain points and provide the tendon movements. These pulleys bring the tendons closer to the bone. Around the tendons, there is a thin structure enabling it to run through the tunnels. (tenosinovyum)

Trigger finger is called as the thickening of the pulley found in the base of the finger and sometimes called as the dysfunction and pain during finger movements due to swellings occurred on tendon sheath.  Using the finger after the problem has started causes more swelling of the structures there and even makes it worse. Sometimes finger dysfunction and locking may occur.

Usually the main cause is unknown. It is more frequently seen in systemic diseases such as Rheumatoid arthritis, Gout, diabetics. Traumas to palm and finger base can rarely cause trigger finger.
The trigger finger begins with a feeling of discomfort at the connection point of fingers in palm. There is sensitivity to pressure on this point where sometimes nodules are felt. In following periods the finger starts to dysfunction and lock.

The aim for the treatment is to prevent dysfunctioning of the finger and to remove the feel of discomfort during its movement. Reducing the swelling of flexor tendon and the tendon sheath enables it to run easier during its movement. Following this aim, reducing the activities, usage of oral anti-inflammatory drugs and cast are preferred for the patients who have earlier symptoms. Injection of the location with steroids may help reducing of the symptoms, but we do not use them due to their harms to the structures of tendons on the long view. 

In cases that lasted long and have not responded to medical treatment, the surgical loosening of the pulley that caused the incarceration is the necessary treatment option to choose. The operation is performed with a small cut in the palm under local anaesthesia. It is important to take vessel nerve structures that are close to the tendon sheath under protection during the operation. In post-operational period, the symptoms reduces and never repeat especially after a successful surgery. In some patients, hardness on injury point may occur due to extremely improved tissue, which usually recedes in time by the massages performed at home.

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