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In February, OrthoCarolina took you inside the operating room at Mallard Creek Surgery Center as we streamed a trigger finger and carpal tunnel surgery live on Facebook. Our surgical team, Dr. Christopher Chadderdon and Dana Cumberworth, PA-C, invited viewers to ask questions along the way.
-DID YOU MISS OUR LIVE SURGERY? IT CAN STILL BE VIEWED IN ITS ENTIRETY-
Keep learning more with us about these procedures. Here are all the questions we received from viewers throughout the process and answers from Dr. Chadderdon and Dana:
What are the symptoms of trigger finger and why are they occurring?
The tendons that flex your fingers do so by gliding through a tunnel. When someone has trigger finger, this pulley system becomes too tight and the tendon becomes trapped in the tunnel. This causes the individual pain and can result in a popping or catching sensation. This can often be seen when the patient makes a fist, then tries to release the fist. That trigger finger gets stuck along the way, then pops back into place.
Learn more from Dr. Chadderdon in our ABCs of Orthopedics video series: Five Symptoms That Point to Trigger Finger
What symptoms does someone with carpal tunnel experience and why?
There is a nerve in the palm that lives inside a tunnel and the carpal tunnel condition occurs when the area becomes too tight. Symptoms include numbness and tingling that can be felt in the thumb, index, middle and ring fingers. For some patients, the pain and numbness are constant while for others it comes and goes or even wakes them up at night. They may also experience symptoms during activities like driving or blow-drying their hair.
Is surgery the only option for these ailments?
Dr. Chadderdon says that both trigger finger and carpal tunnel are conditions he tries to manage without surgery. With trigger finger, for example, he often has the patient try one or two steroid injections, which 60-70% of the time. If all non-surgical options are exhausted without improvement of the condition, this is when Dr. Chadderdon would recommend surgery.
The patient in this surgery was awake. Is that normal and could I watch my own surgery?
Trigger finger and carpal tunnel procedures are each about five minutes in length. Many small, common surgeries can be done with the patient completely awake using local anesthetics. This all comes down to patient preference. While staying awake is an option, patients can also elect to have mild sedition, like the twilight sleep medication given with a colonoscopy.
For patients who stay awake during trigger finger surgery, Dr. Chadderdon does often give them the chance to see their hand moving freely without catching or locking once he has performed the surgical release. Because of the numbness, patients may not be able to feel that their condition has been repaired and by taking down the sheet, Dr. Chadderdon gives them the option to see for themselves.
If you have multiple trigger fingers that require an operation on one or both hands, what happens next?
Dana says she and Dr. Chadderdon have operated on multiple trigger fingers at a time for patients, even four at a time on one hand. By taking care of all the trigger finger complications at once, a patient isn’t returning for multiple procedures or experiencing multiple recoveries. When several procedures are done at once, the only difference in recovery may be that bandages are worn for a bit longer to accommodate the additional stitches.
What is recovery time like? Will the patient need to wear a brace or do physical therapy?
After stitches finish up the successful surgery, viewers saw Dana apply a petroleum antibiotic ointment to the incision locations to help stop any post-surgery bleeding or oozing. The ointment also allows the soft wrapping of the gauze applied to not stick to the stitches. Dr. Chadderdon recommends leaving this bandage on for five days and not getting the hand wet. Otherwise, the patient can immediately return to basic activity like writing, typing and food preparation. This means those with desk jobs return to work in just a few days while those with heavier lifting jobs, like construction, may be out for two to four weeks.
Does the released tunnel grow back or remain open?
Tendons glide through a tunnel to move your finger and when this tunnel becomes too tight, you can see the symptoms of trigger finger. Once that tunnel is released during surgery, it is opened up. Dana says that realistically, the opened space does fill up with something, like scar tissue, but that the tunnel is now wider. After surgery, there is a small likelihood, less than 5% odds, that the trigger finger will return.
- Inside the OR - Watch Dr. Chadderdon and Dana perform these trigger finger and carpal tunnel surgeries
- Dr. Chadderdon shares the 5 Symptoms That Point to Trigger Finger
- Be sure you're caring for your hands with these three recommendations from Dana
- Stop pain before it starts - A focus on Everyday Ergonomics will set you up for a healthy workspace