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What is trigger finger?

What is trigger finger?Trigger finger, also known as Tenosynovitis Stenosing, is the contraction or locking of fingers or thumb during movement (especially bending).

 It is very difficult to restore the locked finger and causes a lot of pain in the patient.
What causes trigger finger?
Tendons are tough bands of tissue that connect muscles and bones with your finger or thumb. Tendons bend and straighten the muscles in the hands and arms, fingers and thumbs, and more. A tendon glides easily through the tissue (also called sheath) that covers it, usually thanks to the synovium, a lubricating membrane that surrounds the joint. Prolonged irritation of the tendon sheath can cause scarring and thickening that affects the movement of the tendon. When this happens, bending your finger or thumb pulls on the inflamed tendon. Trigger finger can also occur when tendons become inflamed. This causes compression and swelling. It is usually caused by a repetitive motion or regular compulsive use of the fingers. In short, the cause of trigger finger disease is the inability of the tendons to function as they should.

What are the symptoms of trigger finger?
Trigger finger can affect any finger, including all fingers. More than one finger can be affected at a time and can happen on both hands. The symptoms of trigger finger are similar in many people. These:
• Hard fingers when waking up in the morning
• A clicking sound when moving the fingers
• Locking of the finger or fingers straight or bent in the middle, making it difficult to move
• Palm tenderness, lump (nodule) sensation on the part of the affected finger or fingers

In whom is trigger finger more common?
Trigger finger usually occurs between the ages of 40-60. The incidence of trigger finger in women is higher than in men. Diseases such as diabetes, gout, and rheumatoid arthritis can cause trigger finger. It is more common among people working in occupational groups that repetitive finger and thumb movements, such as farmers, industrial workers, musicians.

How is trigger finger treated?
Trigger finger treatment is divided into two as surgical and non-surgical. The main purpose of both treatments is to reduce swelling and restore the old catching motion to the fingers. The first preferred method is, of course, non-surgical, but if the methods do not help, trigger finger surgery may be required to enable the patient to use their finger functionally again.

How is trigger finger diagnosed?
Imaging methods are not used in the diagnosis of trigger finger disease. Diagnosis is made by patient history and physical examination. The specialist doctor can diagnose trigger finger by detecting palpable nodules and finger snags during physical examination.

How is non-surgical trigger finger treatment applied?
The non-surgical method is generally used for people with mild trigger finger. Splint use or drug therapy may benefit patients. Since trigger finger is usually the result of compulsive movements, avoiding compulsive movements whenever possible is the most critical point of non-surgical treatment. Finger exercises can only be effective in mild trigger finger patients.

What are trigger finger surgeries?
There are 2 types of surgery options preferred by surgeons in the treatment of trigger finger. These are open surgery and percutaneous release surgery. Both operations take an average of 20 minutes and the person does not need to spend the night in the hospital after the operation.
Open Surgery: In the treatment of trigger finger with open surgery, a small incision is made in the palm. The tendon sheath is then cut, leaving more room for the tendon to move. He then sutures the incision to close the wound. Generally, when this method is applied, the patient is given local anesthesia. This method is more preferred by surgeons.
Percutaneous Release Surgery: This surgery is performed under local anesthesia just like open surgery. In order to cut the tendon sheath, the surgeon enters under the skin with the help of a very sharp needle without making any incisions. This type of surgery does not leave any scars. It is not a preferred method as open surgery, because the risk of injury to unwanted tendons is higher.

What should be considered before trigger finger surgery?
The most important point you should pay attention to before the operation is to talk to your doctor about your physical and psychological disorders in detail and to have information about what to do before and after the operation.
• All kinds of blood thinners and vitamins should be discontinued three weeks before the date of surgery.
• The use of multivitamins and nutritional support pills containing components such as Vitamin C, Vitamin D, Vitamin E, Vitamin K, Ginseng, Gingko Biloba, Co-Enzyme Q10 should be discontinued for a while before the operation.
• Smoking and alcohol use should be minimized as much as possible.

What should be considered after trigger finger surgery?
• Normally, there is no scar after closed surgery (percutaneous release surgery). There are small dressings in the places of the holes. These dressings should be renewed at intervals recommended by the doctor.
• Sometimes, due to the volume of the liquid, the trigger may increase for a while after the injection, and there may be drowsiness. These complaints can be reduced by applying ice to the injection site and NSAIDs (anti-inflammatory drugs).
• Immediately after the operation, patients can return to their daily lives in a short time. They do not need to spend the night in the hospital.
• Exercises are started as early as possible to prevent postoperative adhesions.
• Wound healing takes about 15 days. After two weeks, the stitches are removed.
• You can start sports after two weeks, but it is recommended not to force the fingers too much.
• Post-operative swelling usually disappears within two weeks.
• There may be a tingling that lasts only for a week or two after the surgery. These complaints can be reduced with ice application and NSAIDs (anti-inflammatory drugs).
• Lymph drainage or physical therapy may be beneficial for patients, upon the recommendation of a doctor, in order to accelerate the movement after the stitches are removed.
• In some patients, hardness may occur in the wound area due to excessive healing tissue. This usually regresses over time with home massages.
In the postoperative period, the symptoms regress completely in a short time and there is no recurrence after a successful surgical operation.

What are trigger finger exercises?
Trigger finger exercises can provide relief after surgery or in people with mild trigger finger. The most well-known of these exercises is the fist exercise. Make a fist with your hand and then open all your fingers until they are as wide apart as possible. While doing this, it is recommended to do it slowly, if you do it quickly, your fingers may get tired and swelling in the fingers may increase. Another exercise is structure with rubber balls. For this exercise, find a rubber ball that fits in your palm and squeeze it for 10 seconds. Determine which of the trigger finger exercises and how often you will perform them with the approval of your doctor or physical therapist.

What are the ways to prevent trigger finger disease?
Trigger finger disease is a very common disease and there are many conditions that cause this disease. It may be possible to prevent trigger finger by taking into account the conditions that cause the disease. To protect from trigger finger;
• Smartphones should not be used for more than 3 hours a day.
• Hands and fingers should be rested during the day.
• Excessive and fast keyboard use should be avoided.
• Early intervention and ice should be applied when pain is felt.

• The finger with the highest risk in terms of trigger finger is the thumb. Efforts should be made to use the smartphone with both hands whenever possible and not to overload the thumbs.

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