Dr. Henley explained what he would be doing during the surgery and was very calming in the pre-surgery visit. I appreciated the follow up call the next day to check on me, I had a couple of questions and they were easily answered during this call. My follow up visit was good and I was told not to come back unless I had problems, so that was a good thing. Staff at his office was friendly and courteous as well. I appreciated that surgery wasn’t the first thing Dr. Henley suggested, he first injected my finger and waited to see if surgery was needed. That was just a short fix,about 3 months, but it seems as if the surgery has fixed it. I’m still sore and have a little tingling, but it seems to be getting better, no more painful finger “lock ups”!
The scenario listed above points to a diagnosis of trigger finger. In this condition, the disparity in size between the flexor tendon and the surrounding retinacular pulley system, most commonly at the level of the first annular (A1) pulley, results in difficulty flexing or extending the finger and the “triggering” phenomenon. Metacarpophalangeal locking should be included in the differential, where the collateral ligament or volar plate tethers on a prominent metacarpal head or osteophyte.
The referenced text notes that a series of two corticosteroid injections should be given before surgery is considered for A1 pulley release. Mention is also made of the possibility of diabetics being more resistant to injections, with surgical release being a cost-effective treatment for this patient population.
Illustration A shows the clinical appearance of this disorder.