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Trigger Thumb The tendons in your thumb go through a tight fibrous tunnel. The analogy of a trigger thumb is very similar to a bicycle brake cable, which has a white plastic sheath and a metal wire that runs in and out of the plastic sheath. If you have a lump on the piece of metal it will get snagged as it tries to get in and out of the plastic. Essentially you have a lump on your tendon, which is trying to go in and out of a tight tunnel and your finger does not like it and nor do you! ANAESTHETIC General or regional anaesthetic. OPERATIVE PROCEDURE This procedure can be done under a local anaesthetic or general anaesthetic. Generally a "V" shaped incision is made in the base of the palm side of your thumb. Nerves are identified on either side of your thumb before identifying the entrance of the tunnel through which the tendon passes. The entrance of the tunnel is then released so that the tendon flows freely. The wound is then stitched. POST OPERATIVELY A sticky dressing is applied to the wound and a bulky dressing is placed on top of that. The patient goes home the same day in a high arm sling for 48 hours. The sling and bulky bandage is then removed but the sticky dressing is left intact for a period of two weeks. The patient needs to keep the wound dry for that time. Return to work Patients can return to work between 48 hours and 3 weeks post-operatively. RESULTS The operation is about 95% successful. COMPLICATIONS
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