Finger On The Trigger! – Dr Ahmad Mahyuddin

Can you imagine your finger on the trigger of a gun? Well, that’s the position of the finger when my patient complained that he couldn’t straighten his finger when he wanted to unclench his fist. Have you ever experienced this?

Trigger finger is caused by inflammation and thickening of the covering of the flexor tendon to the fingers, which also known as the A1 pulleys. The exact aetiology remains unknown. It is more common in patients with Diabetes Mellitus, especially ladies in their 40s to 60s. It can also occur following trauma to the region. I see many cases of trigger finger that occur in a dominant hand in patients having occupation related to many activities of the hand such as sewing and typing.

Patients initially come with pain at the palm at the distal palmar crease, where the A1 pulley is located (see picture). If left untreated the affected finger will lock when the patient bend his finger. He may need to use his opposite hand to straighten it. In severe form, the affected finger will be jammed in bent position.

If the patients come early, we may be able to treat it with physiotherapy and anti-inflammatory medications. Occasionally, steroid injection may be needed. However, if the affected finger is already locked in bent position and one needs assistance to straighten his finger, the surgery is necessary. The operation is usually done under local anaesthesia, where the A1 pulley is released via a small 1cm incision at the palm.

If you have this problem, do seek medical attention early.

 

Dr. Ahmad Mahyuddin is an orthopedic surgeon working in Pahang. Know more about him in The Team page. This article is a translation of Jari saya jammed doktor! by the same author.

 

[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.] 

 

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