Published On: Wed, May 15th, 2013

“Trigger finger: a common ailment in premenopausal women, diabetics and patients with other metabolic conditions”

Post- Percutaneous Treatment  (1)Miami - Trigger Finger (Stenosing Tenosynovitis) is a common musculoskeletal disorder characterized by the inflammation, snapping, catching and/ or locking of the involved finger. The descriptive name of “trigger finger” is used because when the finger unlocks, it pops back suddenly, as if releasing the trigger on a gun. Often painful, trigger finger is caused by a thickening of the tendon sheath (tenosynovial membrane) passing through a narrow anatomic tunnel (A1 pulley). Active people with manual jobs susceptible to more painful aggravation but this is NOT the primary cause, despite popular belief. It is also more common in women than in men and occurs more often to those between the ages of 40 to 60. People with certain medical problems, including diabetes, gout, hypothyroidism, and rheumatoid arthritis, are more likely to develop trigger finger. The triggering is usually more pronounced late at night and into the morning, or while gripping an object firmly.

Trigger Finger Treatments

  • Ultrasound-Guided A1 Pulley Injection Technique- A steroid is injected into the inflamed affected site. Patient is encouraged to move digit regularly. Follow-up appointment is made for 3-4 weeks after treatment.
  • Percutaneous Trigger Finger Release- This is a same day procedure allowing the patient to return home immediately afterwards. It is a newer option available, which allows for the opening of the tendon sheath using a needle-like device permitting the tendon to slide, taking care of both the catching of the finger and the pain. This treatment is performed as an in-office minor procedure under minimal local anesthesia.  The patient is able to remove their own dressing the following day and never requires therapy. Usually no follow-up appointment is necessary because no incision is made.
  •  Open Trigger Finger Release- A small incision is made into the palm of the hand at the base of the affected finger, and the tendon is released from the ligament (A1 pulley) that it is catching onto. It is always done under local anesthesia with very a light sedation as an outpatient procedure in the stress-free facility, the Surgery Center at Doral (you can visit www.surgerycenteratdoral.com). Once the tendon has been released, you may be asked to move your fingers and make a fist. It requires one post op visit to check the small wound and NO stitch removal is necessary since they use only 1-2 absorbable stitches. Your hand can be used immediately after the procedure but heavy manual work and sports should be avoided for about a 2-week period.

Pre- Percutaneous Treatment“Diagnosis is made almost exclusively by history and physical examination alone. More than one finger may be affected at a time but the ring finger is by far the most commonly affected, followed by the thumb.” – says Dr. Alejandro Badia world-renowned upper limb surgeon, who just recently traveled to conferences in India, Japan, Dubai, Brazil and the Dominican Republic participating as a speaker on innovative minimally invasive surgical techniques of the hand. “At the Badia Hand to Shoulder Center we have had very successful complication free results with very little need for follow-ups with our innovative minimally invasive procedures to treat Trigger Finger.” - affirms the doctor.

Trigger finger affects 2-3 percent of the population but increases to 10-20 percent of those with diabetes. Its presence is associated with age and duration of diabetes, not necessarily with blood glucose control. In people with Type 1 Diabetes, trigger finger has also been linked to carpal tunnel syndrome, the compression of the median nerve in the hand.

Alejandro Badia, MD, FACS is a hand and upper extremity surgeon. He studied physiology at Cornell University and obtained his medical degree at NYU, where he also trained in orthopedics. A hand fellowship at Alleghany General Hospital in Pittsburgh was followed by an AO trauma fellowship in Freiburg, Germany. He runs an active international hand fellowship, serves on the editorial board of two hand journals, and organizes a yearly Miami meeting for surgeons and therapists that are devoted to upper limb arthroscopy and arthroplasty www.miamihandcourse.com). This international meeting is held at the world-renowned Miami Anatomical Research Center (M.A.R.C.), the world’s largest surgical cadaveric training lab that Dr. Badia co-founded in 2005. In 2008, he completed the Badia Hand to Shoulder Center, a fully integrated clinical facility for the upper limb encompassing digital radiography, MRI extremity imaging, Integra rehabilitation facility and the Surgery Center at Doral. More recently, Dr. Badia inaugurated OrthoNOW, the first immediate orthopedic care center in South Florida which is staffed by surgeons from the International Orthopedic Group (IOG), a group of surgeons from lower extremity, upper limb and spine subspecialties who also treat elective orthopedic problems in international patients. He is member of the ASSH, AAHS, AAOS as well as honorary member of many foreign hand surgery societies and President of ISSPORTH.

Dr. Badia can be reached via www.drbadia.com, a patient education portal and website for hand surgeon academic exchange, by email: alejandro@drbadia.com or by calling 786-245-0590.

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