Operation of the flicking finger

General information on the therapy of the trigger finger

After the patient with a flicking fingers all conservative options (especially the Cortisone Injection), but no permanent healing has occurred, a hand surgeon should be consulted to treat the triggering finger surgically.

The aim of the operation is that Repair the narrow point between the thickened flexor tendon of the affected finger and the ring ligament.

General information about the operation

The surgical therapy of the flickering finger is a small intervention that takes place in local Anesthesia is carried out and mostly only a few minutes lasts.
The patient is usually allowed to leave the practice / hospital immediately after the local anesthesia has subsided and the operated finger can be moved again immediately afterwards. Depending on which Sutures the surgeon has used the sutures after approx. 10 days need to be removed, as there are also self-absorbable sutures that do not have to be removed. However, it depends on the procedure which suture material is used.

Appointment with Dr. Gumpert?

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Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

In order to be able to treat successfully in orthopedics, a thorough examination, diagnosis and a medical history are required.
In our very economic world in particular, there is too little time to thoroughly grasp the complex diseases of orthopedics and thus initiate targeted treatment.
I don't want to join the ranks of "quick knife pullers".
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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  • Lumedis - orthopedic surgeons
    Kaiserstrasse 14
    60311 Frankfurt am Main

You can make an appointment here.
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For more information about myself, see Lumedis - Orthopedists.

Course of the operation

The doctor makes an approx. 1 cm long skin incision on the inside of the hand over the affected tendon, opens the tendon sheath and this cuts the ring ligament.

First of all, the doctor must inform the patient in detail about the upcoming operation with possible complications at least 24 hours before the planned procedure enlighten and the patient must consent.
On the day of the operation, a Bloodlessness of the hand to be treated and then a Tourniquet created. Thus, the operation can be performed without major bleeding. This tourniquet may only be maintained for a short time in order not to endanger the blood flow to the hand.
Then one is injected Local anesthetic (local anesthetic) to the region to be operated on. It can take a few minutes for the full effect to take effect.
This is then done sterile Washing of the operating area and sterile covering of the finger. This is to avoid infections in the area of ​​the wound.
Now the doctor places a small, approx. 1 cm Long skin incision on the inside of the hand over the affected tendon, which is the cause of the triggering finger. The Tendon sheath is opened and the ring ligament is cut. Now the skin is closed again and the fresh scar is protected from infection with a bandage.

Complications of operative therapy

As with all operations, complications can also arise when treating a flickering finger. However, these are extreme Rare.

  • It comes to one Spread of germs from the skin to the tendon sheath, it can become a infection with attacking the tendon, des Cartilage or des Bone come. If the first signs of infection (pain, reddening, fever) are found in the days after the operation, you should get one immediately antibiotic Therapy to be taken. This can almost always prevent the infection from spreading further.

  • It can too allergic reaction of the patient come against the sutures or the anesthetic used. If the patient is aware of any allergies, it is essential to inform the doctor in advance. However, allergic reactions can usually be treated quickly by the doctor with medication.

  • It can become a excessive scarring (Keloid) come. If this leads to a functional restriction of the finger mobility, an attempt can be made to correct this with plastic-surgical methods.

  • When cutting into the skin and the underlying tissue, the injury can be smaller annoy or. Vessels come. As a result, this can lead to numbness and circulatory disorders in the operated finger.

  • If the ring ligament that was severed during the operation heals again, a finger may develop again. This can only be remedied by renewed surgical therapy.

Overall, however, this form of therapy is the trigger finger very promising. Almost all patients are then relieved of the symptoms of the flickering finger.

Sick leave - how long sick?

A quick finger is usually treated surgically. In many cases, however, patients are after the operation not immediately fully applicable in their job again. Therefore, for many, the question arises for how long after the operation a sick leave is made. Unfortunately, there is no general answer to this question each patient different is. In addition, different patients have different jobs. While a craftsman or construction worker uses his finger a lot every day, a bank employee is less affected by a restriction. The attending physician will always take these differences into account.

In all cases will be the stitches are removed after about a weekUntil then, the finger should also be due to the postoperative swelling immobilized become. In principle, movement is possible immediately after the anesthetic has subsided, but no movement is recommended out of consideration for the suture.

A Sick leave so takes place at least for a week, in exceptional cases (heavy, work-related physical strain) up to two weeks.

Aftercare

After the flickering finger has been operated on, it should immobilized until the sutures are removed become. On the one hand occurs after the operation naturally one swelling of the treated finger. To keep this swelling as low as possible, it is advisable to use your finger to store up, in the optimal case above heart level. The higher a wound is placed, the lower the pressure exerted against the suture by the heartbeat. In addition, gravity helps to drain excess tissue fluid downwards.

On the other hand, the sutured skin should be during the healing phase not too large tensile and compressive loads otherwise the seams can tear. As a result, they would have to be re-applied, depending on the healing stage. The sutures can be removed after about a week. This does not necessarily have to happen in the hospital, it can from the family doctor be performed. The removal of the seams causes a maximum of one light pulling, but normally it runs completely without pain. Follow-up care in the form of a physiotherapy is usually not necessary. Since the intervention is only very small ("microsurgical“), No major complications are to be expected.

Pain

Pain occurs during surgery of the flickering finger usually not on. During the operation a Local anesthetic injected into the finger, which numbs the sensitive nerve tracts, and everything Turns off sensation of pain.

After the operation, the The pain reliever wears off there is a flare-up of pain. Since that swollen tissues If the finger presses on the nerve tracts, this leads to irritation and pain as a result. Mostly the pain is throbbing and increases if you let your arm hang down. Therefore, it is also important to keep your arm up to minimize pain.

Support can be given in the first few days after the operation also a Painkiller be taken. Usually freely available painkillers are used for this purpose NSAIDs-Class prescribed that are not subject to the Narcotics Act. examples for this are Paracetamol and Ibuprofen. However, ingestion should not flat ratelbut rather the actual pain, as it increases with long-term use of NSAIDs Stomach discomfort, diarrhea and heartburn can come.