Hand Surgeon Questions

Trigger finger caused by ulnar/median nerve surgery?

I had ulnar & median nerve surgery back in July, with documented clawing of my 4th & 5th digits prior. After surgery the clawing has somewhat gotten worse and I’m unable to physically open my fingers at all. They will move down towards my palm at the bottom joint, but neither joint on my finger moves. It looks to me like there is significant atrophy and the skin on my fingers has shortened & wrinkles as if it’s being pulled. My surgeon said he’s never had an outcome like this & said it’s possibly permanent nerve damage. My regular Dr says I just need to go to another surgeon and get some shots to loosen the tendons. Is this trigger finger cause by tightening tendons or nerve damage?

Female | 40 years old
Complaint duration: 6 months
Medications: N/a
Conditions: Cubital tunnel @ elbow & wrist, carpal tunnel

2 Answers

Hellio,
I doubt this is "trigger finger" and likley will not improve with cortisone injections. A follow-up evaluation and an NCV/EMG might help determine if there is entrapment that can be addressed.
Best,
Dr. L
Clawing in the small and ring fingers can be due to a muscle imbalance created by weakness in the hand muscles or intrinsics, compared to the power of muscles that originate in the forearm and attach to the fingertips to flex or bend the fingertips called the extrinsics. As clawing persists it can lead to contracture. Speak with your surgeon about this.