When to seek
stiffness or catching in a finger joint to the attention of your doctor
so that he or she may review your symptoms and perform a physical
evaluation of your hand. Seek immediate medical care if a finger joint
is hot and inflamed because this may indicate an infection.
How is it Treated?
Conservative (non-surgical) treatment is an appropriate
first step, unless the finger or thumb is in an unmovable, locked
position. Initial treatment involves avoiding or modifying those
activities that have caused the inflammation.
The physician may decide to restrict movement of the joint by means of a
splint. Oral anti-inflammatory medications are often used to reduce
inflammation and discomfort. Anti-inflammatory medication may also be
administered directly into the tendon sheath by means of an injection to
reduce the soft tissue swelling.
In cases that do not respond to conservative treatment, or if the finger
or thumb remain in a locked position, surgery may be recommended.
Surgery is performed on an out-patient basis under a local anesthetic. A
transverse or zigzag incision is made in the palm of the hand at the
base of the affected finger or thumb. In most cases the surgeon will
simply release (cut) the first annular band, relieving the constriction
of the tendon as it passes through the sheath. The patient may be asked
to actively move the tendon during surgery to confirm whether the
triggering has been relieved.
In cases involving inflammation of the lining of the tendon, such as
arthritis, it may be necessary to remove the thickened synovial covering
and other tissue surrounding the tendon.
Following surgery, a light dressing is applied to protect the wound yet
allow for active and passive motion of the finger or thumb. The dressing
may be removed after several days. It is recommended that the hand be
kept dry until the sutures are removed, usually 10-14 days following
surgery. Activities requiring use of the affected hand may be restricted
for 4-6 weeks.