The most common treatment of trigger finger is with injection of steroids (cortisone injection) into the flexor tendon sheath. The cortisone injection should decrease the swelling within the tendon, and restore the normal mechanics of the flexor tendon mechanism.
Preparing yourself for finger joint replacement surgery can seem like a stressful and daunting task. Planning ahead of time for your surgery and hospital stay can have a positive impact on the success of your surgery. This section can help you learn about preparing for your finger joint replacement surgery.
The finger joints work like hinges when the fingers bend and straighten. The main knuckle joint is the metacarpophalangeal joint (MCP joint). It is formed by the connection of the metacarpal bone in the palm of the hand with the finger bone, or phalange. Each finger has three phalanges,
separated by two interphalangeal joints (IP joints). The one closest to the MCP joint (knuckle) is called the proximal IP joint (PIP joint). The joint near the end of the finger is called the distal IP joint (DIP joint).
Ligaments are tough bands of tissue that connect bones together. Several ligaments hold the joints together in the finger. These ligaments join to form the joint capsule of the finger joint, a watertight sac around the joint.
The joint surfaces are covered with a material called articular cartilage. This material is the slick, spongy covering that allows one side of a joint to slide against the other joint surface easily. When this material wears out, the joint develops a type of arthritis called osteoarthritis and becomes painful.
How should I do to prepare for surgery?
The decision to proceed with surgery must be made jointly by you and your surgeon. You need to understand as much about the procedure as possible. If you have concerns or questions, you should talk to your surgeon.
Once you decide on surgery, you need to take several steps. Your surgeon may suggest a complete physical examination by your regular doctor. This exam helps ensure that you are in the best possible condition to undergo the operation.
On the day of your surgery, you will probably be admitted to the hospital early in the morning. You shouldn't eat or drink anything after midnight the night before. The length of time you spend in the hospital depends a lot on you.
Surgery can last up to 90 minutes. Surgery may be done using a general anesthetic, which puts you completely to sleep, or a local anesthetic, which numbs only the hand. With a local anesthetic you may be awake during the surgery, but you won't be able to see the surgery.
Once you have anesthesia, your surgeon will make sure the skin of your hand is free of infection by cleaning the skin with a germ-killing solution.
An incision is made on the back part of the finger over the surface of the joint that is to be fused. Special care is taken not to damage the nearby nerves going to the finger.
The joint capsule surrounding the finger joint is then opened so that the surgeon can see the joint surfaces. The articular cartilage is removed from both joint surfaces to leave two surfaces of raw bone. The bottom of the phalange is hollowed with a special tool to form a socket. The other surface is shaped into a rounded cone that fits inside the socket.
ComplicationsWhat might go wrong?
As with all major surgical procedures, complications can occur. This document doesn't provide a complete list of the possible complications, but it does highlight some of the most common problems.
Some of the most common complications following finger fusion surgery are :
- nerve damage
Frequently Asked Questions
To begin, your physician will ask you some background questions regarding your hand history and any injuries you may have incurred. A physical examination will be performed and x-rays will be taken to identify the severity of your situation. In addition, in certain cases your surgeon will order blood tests. At this point, your surgeon will use his/her expertise to diagnose your condition.
How does the implant perform when it is inserted into my hand?
The implant or prosthesis acts as a spacer to fill the gap that was created when the arthritic surfaces of the MCP (metacarpal phalangeal joint) or PIP (proximal interphalangeal joint) are removed.
What is the implant made of?
The implant is made of medical grade silicone.
How do I prepare for this surgery?
At least one week prior to hospital admission, you will need to visit your family physician or an internist to have a check up. If you are over the age of 40, you will most likely need to have a chest X-ray and an electrocardiogram (EKG) performed, in addition to appropriate blood and urine tests.
If you smoke, it is important to stop two weeks prior to surgery and to consider quitting all together.
Can I only get one joint replaced at a time, or can my surgeon replace multiple joints at once?
Your surgeon can replace all diseased joints in one hand during one surgery. When that hand has recovered, the other hand will have the necessary joints replaced. Most of the time, the surgeon will not do both hands at once.
What state will my hand and arm be in after surgery?
Your arm will be elevated and immobilized in a splint, so you will not be able to move your hand. Blood staining may also be visible through the dressing for the first few hours after surgery.
What is the follow-up protocol for finger replacement surgery?
You will most likely be seen by your surgeon various times after your surgery (i.e. 1 week, 3 weeks, 6 weeks, 3 months and 6 months). X-rays may be taken during these follow up exams if your surgeon feels they are necessary.
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