Trigger finger
It represents a thickening of the flexor tendon of a finger at the level of a pulley (canal) through which the tendon glides.
Depending on the severity, the finger may lock in flexion, requiring passive unlocking with the opposite hand, or it may cause only a “catching” sensation during the flexion movement.
Other symptoms include pain, stiffness of the affected finger or the entire hand, and palmar swelling at the base of the respective finger.
Risk factors include intense physical work (gardening, heavy industry, etc.), playing musical instruments (piano, accordion, etc.), or being a professional athlete (tennis players).
Patients frequently exposed to this pathology include those with rheumatoid arthritis, gout, diabetes mellitus, and thyroid disease.
The diagnosis of trigger finger is made based on the clinical examination by the plastic surgeon and the exact affected site is confirmed by musculoskeletal ultrasound.
Treatment is purely surgical and performed under local anesthesia through a minimal incision (approximately 1 cm) at the site indicated by the ultrasound.
Immediately after the surgery, the finger locking disappears, although pain may persist for up to 4–6 weeks.
Post-Traumatic Hand/Foot Tendon Repair
Depending on the type of affected tendon (flexor/extensor), a supra-lesion incision is performed.
Types of anesthesia required for tendon repair:
Local anesthesia, in approximately 60% of cases;
Regional anesthesia, in approximately 30% of cases;
General anesthesia, in approximately 10% of cases.
After making the incision under one of the anesthesia types mentioned above, the ends of the severed tendon are brought end to end and sutured using a special type of suture appropriate for the tendon type and the injury.
If there is a tendon defect and the ends cannot be brought together, tendon reconstruction with a tendon graft is necessary. The graft is harvested either from the same tendon or from another tendon.
After the surgical repair of the tendon, the skin is closed with sutures designed to minimize scarring, and the affected limb is immobilized in a plaster splint.
Immobilization is required for 3–6 weeks, during which time the patient cannot use the affected limb (hand/foot).
