Dr. J. Michael Bennett: Hello. My name is Dr. J. Michael Bennett. I'm a member of the
Fondren Orthopedic Group. I am a board-certified orthopedic surgeon who's subspecialized in
sports medicine and surgery of the shoulder, elbow, and knee, as well some hand surgery.
Today, we're going to talk about a very common pathology that we see in a lot of patients
and that's called the trigger finger or a locking finger. Most patients will present
with a severe pain with flexion of the finger where they cannot bend their finger due to
pain or locking sensation at the base of the finger. It's very common in patients that
work a lot with their hands or it can be seen in patients that are diabetics. Sometimes,
it will be associated with some sort of trauma to the finger at the tendon itself. But often
times, they'll get a locking sensation in the finger followed by pain, and then they'll
usually feel a pop. If you palpate the base of the finger, sometimes, you'll feel a nodule
there and usually, that just means the tendon is swollen.
So each to these tendons are going through a number of tunnels in the finger that allow
you to bend and extend the finger. They're called pulleys, and when the tendon gets inflamed,
it has to squeeze through that pulley. This is a very crude picture here of a hand, and
it's just showing you one of the pulleys here that's involved. This is actually the A1 pulley.
It's called the A1 pulley. And so what happens is that you have an inflamed area of the tendon
that creates a nodule. And that nodule, if a tendon get swollen, it has to slide in and
out of that little pulley. As that tendon gets crammed through that pulley, it gets
locked and it gets stuck, and it can become painful. Sometimes, we can treat this with
anti-inflammatories and it can go away in very mild cases. Sometimes, the doctor may
even inject a little bit of steroid right along this tendon sheath here to see if that'll
help decrease the size of the tendon, help with the inflammation, and allow the tendon
to glide a little bit easier.
But if you continue to have locking or triggering, the third option is actually going in there
and doing a release, where you do make a little incision in the region at the palm here, and
you release that pulley. You actually make a cut there. When you release the pulley,
it opens up this sheath here. That sheath gets opened up, and it allows the tendon to
glide back and forth without getting caught up into that pulley. It's important that if
you do decide to try an injection that you do not get multiple back to back injections.
You want to give yourself plenty of time before you a get a second injection because steroid
injections aren't necessarily good multiple times back-to-back. You usually want to give
yourself at least a few months before you get a repeat injection because it can be associated
with tendon ruptures. However, that should be discussed between you and your doctor.
This is a very successful procedure in regards to taking care of the locking issue with the
tendon. If you have any questions or comments, please feel free to go to our website at www.orthopedicsportsdoctor.com
or give us a call at our office at (281) 633-8600. Thank you very much.