The tendons that bend our fingers run through a series of pulleys, called the flexor sheath. The tendon can become thickened and inflamed and have difficulty passing through the tunnel. The first pulley called the A1 Pulley is usually the site where the tendon gets stuck. This will manifest in the patient as:

- Clicking

- Locking - finger gets stuck

- Reduced bending of the finger

- Pain

Why does it occur ?

There is no identifiable cause, however it can be associated with diabetes, arthritis or increased manual activity.

Non Surgical Treatment

1. Finger splints worn at night

2. Steroid injections - may last up to 6 months. Can be repeated.

Surgical Treatment

Trigger digit release - performed as a short day case procedure under local anaesthesia. A transverse incision is made in the palm and the thickened pulley is released. Intraoperatively motion is tested demonstrating improved glide. Trigger digit can also occur in the thumb and the A1 pulley can be released at the thumb base (see picture)

Risks of Treatment

Infection

Pain

Nerve injury

Tendon rupture

Stiffness

Altered colour (steroid injection)

Painful scar

Complex regional pain syndrome

Trigger Digit Release

Anaesthetic : Local Anaesthetic

Operative time : 15 minutes

Hospital Stay : Day Case

Time off work : up to 1 week (Depends on occupation)

Recovery Time : 2 weeks