A trigger digit is a thumb or finger that gets stuck in a curled down position, but can usually be brought straight by the patient either using force with the affected finger, or using their other hand. This happens because as we get older we form little nodules in our flexor tendons, the tendons on the front surface of the hand. These tendons run through very tight pulleys, to make the finger stronger when gripping objects. However, with age these pulleys can thicken and then the nodules can no longer run smoothly through the pulleys and get stuck.
Mr Wharton offers steroid injection in the clinic for trigger digits. This condition is very responsive to steroid injections, and around 2/3 of people will be cured with a single injection. If a first one doesn’t work then a second may be helpful. Should those fail, or if the patient prefers it, Mr Wharton offers trigger release surgery under local anaesthetic. The palm is numbed with anaesthetic injections, and a small cut is made over the first pulley which tends to be the one causing the trouble. This can then be divided and released, and the tendon usually then glides smoothly, without any loss in strength. After the surgery the patient should elevate their hand for at least five days, and keep the wound dry for at least two weeks. Often the tendons can get stuck to each other because of the inflammation, and if that is the case Mr Wharton will recommend hand therapy exercises to help them glide differentially.