These are Dr. Knight’s own words from the video. We corrected the anatomy and drug names the automatic captions got wrong and added the punctuation. Nothing he said was changed, added or taken out.
Host: Even as small as joints in our bodies can obviously cause us pain, as was the case for Leslie. Let's look at her story.
Leslie: About two years ago I woke up and my thumb was in extreme pain. When I actually bent it, it felt like it was breaking, and, but doctor told me I have trigger finger. This is as much as I can move it without pain right now. Day to day activities have become very challenging and difficult to do. Brushing my hair, using the curling iron, it affects everything that you do. I am so excited to get this problem resolved.
Host: Let's see how Leslie's surgery went.
Dr. Knight: Good morning. I know it's painful. Try to bend for me if you can, and just, let's look compared to the other thumb. Bend as far as you can, just kind of show the difference here. So that's how, all you can bend the left thumb. Okay. The condition is called a trigger digit, or in this case trigger thumb. I'll make a little cut through the skin here, and then I'll be looking at the band. I'll make a little snip of that band, and then we'll wake you up, and then three stitches later you're done.
Leslie: How long was the actual procedure take?
Dr. Knight: It's going to take about five to ten minutes total time. I think you'll see marked improvement, your mobilities, and while you're on the operating room table.
Leslie: And looking forward to bending my thumb again.
Dr. Knight: Now we're just gonna make a little incision for the crease of the thumb, and we're just going through the tissue to, down to the tendon. Here's the band we're gonna snip, and I'm just going to put my scissors right underneath this band.
We're just gonna wash the wound out with some antibiotic solution and put a few stitches.
This is what she couldn't do before surgery. Bend your thumb all the way for me, sweetie. There you go. See that? Right, she could see the, got the tendon completely released. Now she has full mobility. I think Leslie will be happy. Look at her right now, she's moving it completely.
Leslie: Hey, you know, good. I mean, my thumb, I can move it. I'm so excited, look at that.
Host: I'm here with hand surgeon Dr. John Knight from the Hand and Wrist Institute in Beverly Hills, California, along with this patient Leslie. So before we talk a little more about what this trigger finger is, can you show us?
Leslie: Oh, I can bend my thumb. I'm getting all the strength back. It's, I wish, I don't see it catching. Nope. No pain, no pain.
Host: Wow. Okay.
Leslie: And I wish I would have done it a year and a half ago.
Host: Well, I'm glad that you came to get resolution. A lot of people suffer from a trigger finger, right?
Dr. Knight: Right, it's the most common procedure we take care of as a hand surgeon, more common than carpal tunnel.
Host: So let's show people what trigger finger is. I know we have an illustration here.
Dr. Knight: Sure. On the illustration you'll see bands or tendons to go to the tip of the finger, and it's in the palm area that, that you get a little swelling or inflammation around the tendon. Eventually over time you actually may form a nodule, and that nodule is like a rope going through a pulley. It starts to snag. And we have a demo here. I don't know if this is really going to do justice, because it's obviously difficult sometimes with demos, but again, this is the tendon. It's going, it's going through that sheath, and this is one without.
Host: Right, no friction, smooth gliding.
Dr. Knight: And that's, and all the tendons that bend the fingers down go through a system of pulleys, and then there's what the, there's usually the first pulley that's in the palm or at the base of the thumb, and it forms a little knot on it, like this knot on this rope here, or this ball, and it impedes the thumb movement. So when we do the surgery, just snip it, and that relieves the pressure. So by getting rid of that, and it obviously moves freely through the pulley system, as evidenced by your quick recovery.
Host: Are there things that people can do in their daily life to hopefully prevent this from occurring in the first place?
Dr. Knight: Absolutely. Surgery is a last resort. You know, what the first thing is, looking at ergonomics, less repetitive use, too much texting, too much keyboard. Just said as much as you can, you know, over-the-counter anti-inflammatory medicine and just rest. There's a, no, really the hallmark of conservative treatment is a cortisone shot right where the tendon is. If it's mild case, then it can respond favorably of that. In her case though, when you can't bend it at all, that's a pretty severe case, it's not likely to respond to conservative treatment. So surgery is a last resort, but it is an option for people who just have no resolution with conservative treatments.
Host: So happy that you're feeling better.
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