Alan Litt is playing his guitar pain free for the first time in almost ten years. Thanks to hand surgeon Dr. Stephen Troum, a member of the American Society for Surgery of the Hand. Just three months ago Dr. Troum treated Mr. Litt’s trigger finger, a common but very diblitating ailment. Today the two are sharing their passion for music. The pain was excruciating. I was in pain all the time, my hand was locking, my finger was locking up all the time. I was depressed because I couldn’t play and um, but the constant pain.
Was the worst thing. It hurt all the time. So by the time I came in to see Dr. Troum I could hardly open my hand and I didn’t want to. I basically kept it comfortable, in a comfortable fist like this, because that was not aggravating it at all. The pain was 24 hours a day. As soon as, it’s the first thing you think of when i woke up, it was the last thing I thought of when I went to bed. So basically that’s where I was before I had.
The surgery. Well when Mr. Litt came in, he came in with the classic complaints of trigger finger and that is his ring finger was catching on him and locking, and it was very painful. It was interfering with his work but it was also interfering with his activity as a guitar player and a musician. Initially we tried to treat it without surgery and we put him on antiinflamatory medication, we also will try steroid injections into the sheath to try and make the swelling and inflamation go down, but that doesn’t work, then the next step would be surgery. Trigger Finger is basically.
What is Trigger Finger
A tendon problem where you have inflamation in the tendons typically the flexors in your hand, is where it occurs. The inflamation causes swelling around the tendon and that swelling basically causes the tendon to snag inside the sheath giving you this locking or clicking or cathing sensation. Imagine basically like your belt, a series of belt loops and imagine tieing a knot in your belt and you might be able to pull it through the belt loop but it will pop or catch you and certainly if the knot is too big it won’t.
Even pull through. Now imagine cutting that belt loop that belt loop it’s getting caught on. The belt will stay on your waist because you’ve got all the other belt loops holding it there but you’ve caught the one belt loop, cut the one belt loop that is causing the problem. The procedure starts out after we’ve prepped and draped the patient’s hand, made a sterile field, he’s asleep of course and we’ll make a small incision about half an inch or so in the palm overlying that tendon sheath and.
In Mr. Litt’s case it was of the ring finger. So it’ll be an incision sort of in the palm and then we go down to the tendon sheath itself and the pulley, which is called the a1 pulley, it’s the actual structure where the sheath begins, the beginning of the tunnel, as you might think. We insize that pulley and open it up and you can see the tendons underneath and you can actually move the finger and see the tendons gliding the way they should and once you’ve had an adequate release, opened up the sheath enough and the tendons stop.
Clicking you’re basically done at that point. You wash the wound out and close it up. The surgery was easier than getting your teeth cleaned. I mean I went in, they put me to sleep I woke up and badaboom badabing and it was done. So after about three weeks, I had no clicking, my finger was not clicking any more, wasn’t locking up, still hurt. It still hurt from the surgery a little bit but that was to be expected. I was warned about that, and I got to tell you it was something akin to a miracle. It was great. It was fantastic.
I can move my hand again. I can move my finger again, loosely, easily. So if you’re out there and you got trigger finger go see a hand surgeon. That’s my experience. If you want to seek out a hand surgeon and you have a problem with your hand go to.handcare.assh, it’s the website of the American Society for Surgery of the Hand. They have lots of patient education resources on the site as well as a directory where you can put in your city or your ZIP code and find a hand surgeon who is fellowship trained and board certified.