“It is a chronic inflammation of the flexor tendon of the finger, with simultaneous thickening of the digital ligament at the level of the palm. In many cases, the presence of a hard and painful nodule in the corresponding anatomical area is characteristic, so that it can be palpated even by the patient, giving the false impression of a ganglion”, explains Mr. Konstantinos Tolis MD, MSC Orthopedic Surgeon Upper Extremity Clinic – Microsurgery, Metropolitan General. Then Mr. Tolis answers the most common questions patients have about this common hand disease:

1. What are the causes of the disease and what diseases is it associated with?

Chronic inflammation of the flexor tendon of the finger leads to thickening of the anatomical elements surrounding the tendon, resulting in the manifestation of the disease.

An exact causative factor has not been identified to date. It is closely related to Dupuytren’s Disease, while patients with Diabetes Mellitus, Thyroid Disease, Renal Failure and Rheumatoid Arthritis show the disease in multiple fingers.

2. Who does it affect most often?

The thumb, middle finger and little finger are most affected, while both hands are usually affected at the same time.
Right-handed people, women, patients over 40 years of age, and manual workers are more affected.

3. Can it also occur in children?

In children it appears at birth, in infancy, and affects the thumb.
In this case it is referred to as Congenital Popping Thumb.
The incidence is 3 sufferers per 1,000 children, with 25% of cases involving both hands. No difference in appearance has been observed between boys and girls.

4. Is treatment different in infants?

Monitoring of the disease is mainly recommended, given that between the ages of 6 months and 2 years, spontaneous healing is observed in approximately 50% of cases.
After the age of 2 years the spontaneous cure rate does not exceed 10%.
As a result, and especially in the case that the finger is in constant flexion, surgery is required.

5. How does the bouncing finger manifest itself?

In the initial stages, pain occurs at the base of the finger, in the palm, with a simultaneous feeling of stiffness.
As the disease progresses, the stiffness increases, and eventually the finger “locks” in a flexed position.
The manual return of the finger to its normal position is followed by a characteristic “click”, with simultaneous pain.
As the episodes are repeated, the finger ends up in a permanent, painful bend, a condition referred to as fixed trigger finger.

6. Can it be treated conservatively?

The use of rest splints, medication (paracetamol, non-steroidal anti-inflammatory drugs) and injection of topical steroids can sometimes lead to remission of symptoms.

7. When is bunion surgery performed?

Failure of conservative treatment, daily pain, difficulty in carrying out daily activities and constant flexion of the finger, in neglected disease, lead the patient to surgery by a specialized Hand-Upper Extremity surgeon.

8. Can I operate on both hands at the same time?

Simultaneous surgical rehabilitation is not recommended, when both limbs are affected, for reasons of patient safety, but also to effectively manage his daily life (personal hygiene, meal preparation, clothing).

9. Is the surgery safe?

The surgical restoration is performed under local anesthesia, requires minimal surgical time, has a minimal incision (about 1.5 cm) and the patient leaves the hospital the same day.
Postoperative patient satisfaction levels are considered high in the literature.

10. When can I return to my activities?

It is recommended to avoid vigorous manual activity, such as driving, using a keyboard, or using impact tools, for one month postoperatively.
Otherwise, the possibility of swelling and inflammation in the operated area increases, as a reaction to the increased pressure.