Finger Tendon Injection Under US Guidance
A trigger finger is a condition that happens when one of the fingers is flexed and becomes stuck in that position. When trying to straighten it, the finger clicks and snaps and hence the name, as it resembles a cocking of a gun trigger.
This is also called stenosing tenosynovitis, and etiology occurs when swelling and chronic inflammation squeeze and narrow the space around the tendon sheath.
In chronic cases, the finger cannot be straightened and remains in that fixed position.
The procedure is performed typically under ultrasound guidance.
The hand is positioned, upwards, and after a sterile antiseptic preparation over the trigger finger fibrotic tenderness site, an ultrasound examination is done and a short 25-gauge needle is gently advanced under local anesthesia to the line just next to the flexor tendon.
Once the position is confirmed using ultrasound, a small quantity of heat-dilute local anesthetic with steroid is administered.
Visualization of the fluid spread by ultrasound is recorded.
The needle is taken out and Band-Aid is applied. Ice and elevation of the hand can help with any pain afterward.
It is not uncommon to have numbness at the tip of the finger in some instances and local redness.
A follow-up a week or two later is made.
During the time that the finger is improved, it is recommended to have aggressive occupational therapy and gentle hand massage and stretching to allow increased mobility.
