When we consider the amount that the hands and fingers are used in daily tasks, it is little wonder that they rate as the most injured part of the body regardless of the occupation. Trigger finger and trigger thumb are common problems seen by Orthopedic Surgeons. Generally construction and trade workers who operate pistol-gripped power tools, truck and delivery drivers will present as Workers Compensation cases for treatment. This is a condition that affects the tendon in the hand that runs along the under side of the finger or thumb in a pulley like motion, giving the ligaments the name pulleys. Healthy hands and fingers can grip objects and release using this pulley system.

When a worker presents with the condition of trigger finger or trigger thumb, it is usually a result of thickening of the tendon. This thickening can form a nodule from the irritation of the tendon repeatedly sliding through the pulley. Holding the steering wheel for several hours, using power tools for great lengths of time as well as rheumatoid arthritis and some tendon lacerations can cause trigger finger and trigger thumb. When damage is done to the lubricant that allows the pulleys and the tendons to glide, infection can cause a nodule in the tendon.

Workers begin to notice pain when straightening or bending the finger or thumb. There may also be a clicking sensation when bending as well. If a nodule has formed there is general tenderness and swelling affecting it at around the base of the finger or thumb. The pulley ligaments form a tunnel that the nodule passes through when the finger is flexed. When flexing the finger can make a clicking noise, which is the sound of the nodule passing under the ligament. The larger the nodule grows the more difficulty it will have passing under the ligament and it may become stuck, thereby creating a trigger finger or thumb.

The Orthopedic Surgeon can easily diagnose a trigger finger or thumb without the necessity for an x ray. Trigger finger or thumb is an obvious condition based on physical examination. The Orthopedic Surgeon will feel the nodule click as it passes under the ligament, and if the nodule is left untreated then the finger will remain in a fixed trigger position. The Orthopedic Surgeon will discuss surgery options with the patient.

Orthopedic surgery to treat trigger finger involves opening the pulley that is holding the nodule back from allowing the tendon to glide smoothly. Your Orthopedic Surgeon regards this surgery as small and it can be done as an outpatient where the patient may leave hospital on the same day. Most times the Orthopedic Surgeon will make an incision along the crease of the hand, so as to make scarring less obvious once the wound has healed.

The surgery consists of separating the tendon pulley without damaging any of the nerves and blood vessels located nearby. Depending on the lengthy of time that the trigger finger was locked in position, physical therapy is advised. If the finger was locked in position for a number of months then attending a formal rehabilitative program will allow the patient to regain strength and movement in the finger and hand. There may also be heat treatments applied as well as soft tissue massage therapy and a range of stretching exercises to achieve range of motion and strength once more.