Steroid injections and surgery help trigger fingers

SINGAPORE - A Trigger fingers are caused when the tendons (bands of fibrous tissue that connect muscles to bones) that move the fingers get stuck within tight tunnels in the hands.

The fingers move when the muscles in the forearms contract. The muscles in the forearms are connected to the finger bones by long tendons.

These tendons each pass through soft tissue tunnels, called tendon sheaths, within each hand.

Sometimes, because of overuse or degeneration, the tendons or the tendon sheaths swell. This can lead to a tendon getting "jammed" in its sheath.

When the tendon is able to slip past the jam, it clicks and that gives rise to the triggering sensation.

Sleep duration has not been shown to affect trigger fingers.

Based on what you have described, there does not seem to be any obvious cause for your trigger fingers.

Trigger fingers are usually treated first with steroid injections.

This anti-inflammatory medication is meant to help bring down the swelling and inflammation in the finger.

When there is recurrence after the first injection, the same finger can be injected with steroids another time.

If there is recurrence after the second injection, we usually advise surgery.

Trigger finger release surgery is a simple outpatient procedure done under local anaesthesia.

A small incision of about 1cm is made in a skin crease, usually at the base of the affected finger.

This gives the doctor access to a tight horizontal band of tissue there, called a pulley, which holds the tendon sheath and the tendon close to the bone of the finger.

The finger has four other such pulleys.

The pulley at the base of the finger is divided. This frees the tendon and cures the trigger finger.

As the incision is made in a skin crease, any resulting mark after it heals is hardly visible.

Dr Lim Lian Arn, consultant orthopaedic surgeon at Alpha Joints & Orthopaedics at Gleneagles Medical Centre

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