Trigger finger

Surgery can cure trigger finger, relieving frustrating symptoms and preventing the progression of function loss.

Trigger finger is a common, and quite frustrating condition that can arise in any of the fingers or thumb. Patients notice a clicking when straightening out the finger. This can become worse with time, until the finger is painful to straighten after bending, or can even become stuck.

Fingers are bent, or flexed, by tendons that connect muscles in the forearm with the bones in the fingers. These tendons are thick, and rope like. They enter a tunnel at the base of each finger and thumb. This tunnel is there to guide the tendon close to the bone. The tendon sometimes rubs against the entrance to this tunnel and swells, making it hard to straighten out the finger after flexing it. This leads to a cycle where more flexing leads to more damage and swelling. This can become so bag that the finger is stuck and cannot be straightened out without surgery.

Training

Dr Ilias Kotronakis is a fully qualified Australian trained Plastic and Reconstructive Surgeon. He is a native of Sydney, and received his medical degree with first class Honours from the University of Sydney. He went on to complete his internship, residency and registrarship at Royal Prince Alfred Hospital. Dr Kotronakis undertook intensive training in general and Plastic Surgery in Sydney for ten years. After he attained his full qualifications he underwent further training in microsurgery at Charing Cross Hospital in London, in association with the Imperial College of Medicine.

Qualifications

Dr Kotronakis has trained to the highest standards attainable, so you can be sure of his qualifications. He is a Fellow of the Royal Australasian College of Surgeons specialising in Plastic and Reconstructive Surgery (FRACS Plast). FRACS is the standard qualification required in Australia to perform surgery in private and public hospitals, and is the only plastic surgery qualification recognised by the Australian Medical Council. Dr Kotronakis is also a member of the Australian Society of Plastic Surgeons (ASPS). ASPS in the peak Plastic Surgery body in Australia. He is also an International Member of the American Society of Plastic Surgery.

The qualifications that Dr Kotronakis holds mean that he is well trained and has passed rigorous assessment and examination processes. They also mean that he has a commitment to continued education and training. Attending local, national and international conferences and workshops multiple times each year ensures his continued professional development. This means he can advise you of the safest and best treatment available.

Appointments

Dr Kotronakis has extensive experience in sophisticated Plastic and Reconstructive Surgery. He is appointed as a specialist surgeon at Royal Prince Alfred and St George Hospitals. Both are major teaching hospitals. Dr Kotronakis trains registrars in Plastic Surgery at these Hospitals. He is also appointed as a specialist Plastic Surgeon at St George Private Hospital, Kareena Private Hospital and a number of other fully accredited Hospitals. This means that your care is always undertaken in the safest and most comfortable environment.

Does trigger finger always require surgery?

Mild trigger finger with occasional clicking does not need surgery. Symptoms that are annoying, frequent or becoming worse need to be treated.

An alternative to surgery is a steroid injection. This can decrease swelling in the the tendon. This can cure the trigger if the swelling decreases enough to stop the tendon rubbing against the side of the tunnel entrance.

Surgery for trigger finger

Surgery is a relatively simple procedure. It is usually performed under a general anaesthetic (asleep), but it can also be performed under sedation (sleepy) or local anaesthetic (completely awake).

A 1-2 cm cut is made just below the base of the finger, and this is extended down to where the tendon enters the tunnel or sheath at the base of the finger. The entrance is widened, allowing the tendon to move freely.

Most patients go home on the same day.

What to expect after surgery

Surgery is usually very successful at relieving the triggering immediately.

The cut from the surgery is quite deep, and can be sore for some time.  The bulky dressing will stay on for around a couple of days. You will need to be gentle with your hand for the first 4-6 weeks after surgery, and can usually get back to your regular activities after that.

Which hospitals does Dr Kotronakis operate in?

Dr Kotronakis has regular lists at St George Private, Kareena Private, Royal Prince Alfred and St George Hospitals. Carpal tunnel release can be performed at all these hospitals.