The disease involves inflammation of the finger flexor tendon sheath. The tissue surrounding the tendons which flex the finger becomes significantly thickened, which prevents unlimited movement of the tendons. This is manifested in the Patient’s inability to straighten the finger freely. At the beginning, the problem appears after a period of rest, usually in the morning, but with development of the disease – whenever the finger is bent. Swelling at the finger base appears. The finger is straightened “by force” with pain and characteristic clicking sound.
The surgery is performed in the hypoemic area obtained by placement of a compression band over the arm. The treatment involves surgical section or removal of the finger flexor tendon sheath with inflammatory changes, thus allowing unlimited movement of the finger flexor tendon.
The treatment is performed via a short skin section in the bending groove above the change. During the surgery, it may be necessary to extend its scope and execute wide access through the skin to ensure better tendon visibility. The wound is stitched and secured with a cotton and elastic bandage dressing.
Performance of the surgery does not guarantee elimination of the ailments experienced so far. The final treatment effect is closely related with observing the doctor’s recommendations and undergoing the full cycle of rehabilitation treatments, adapted to the individual needs of each Patient.
After the surgery
- For a few days, carry the hand on a sling – this will reduce swelling and pain.
- While lying down, place your hand on a pillow.
- Pain in the hand and finger numbness may persist for several days – analgesic medicines are recommended – in accordance with medicine dosage and administration information.
- Night pains in the hand ought to disappear after the treatment.
- Slight bleeding through the dressing occurs during the first day after the treatment.
- Dressing change is performed during the first or second day after the treatment – the date to be specified by the surgeon.
- Exercising of the operated finger ought to begin during the second day after the surgery, as far as the dressing allows. This will prevent finger stiffness and development of hand swelling.
- Exercise the elbow and shoulder as well.
- Sutures are removed 10 days after the surgery. Until then, try not to keep the hand low, whether during the day or at night.
- Spare the operated hand for 6 weeks (do not perform any work which requires strong grasp with the hand).
Side effects and complications
Performance of any medical intervention involves the risk of side or adverse effects.
These may include body temperature increase after the treatment, temperature increase and skin reddening in the operated area and separation of the wound, which is connected with a prolonged healing process.
The most frequent complication is swelling of the operated hand and pain in the area of the surgical wound. In terms of frequency, the second complication is swelling of the whole limb connected with standstill in venous and lymphatic circulation. This may lead to vein inflammation and thrombosis which requires weeks’ long treatment and deteriorates rehabilitation effects. In some cases, a thick scar develops in the surgery area, with possible pain and sensation disorders. Damage to vessels or nerves in the operated hand and infection of the surgical wound are very rate complications.
The risk of complications is several times higher in emaciated or obese Patients.
- pharmacotherapy: medicines improving nerve functioning, analgesic and anti-inflammatory medicines administered generally (pills, suppositories, intramuscular injections) or locally in the form of ointments, gels and local injections;
- physical therapy – iontophoresis;
- rehabilitation – kinesiotherapy, analgesic and anti-inflammatory physical therapy;
- electrostimulation of the damaged nerve.