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HAND SURGERY

Tendinopathies
(Trigger Finger, De Quervain’s Tenosynovitis, etc.)

What are tendinopathies of the hand?

Tendinopathies refer to painful conditions involving the tendons. The thick cords of tissue that connect muscles to bones. In the hand and wrist, tendons must glide smoothly through sheaths or tunnels to enable fluid movement of the fingers and thumb. When tendons become irritated, inflamed, or degenerate over time, it can lead to pain, stiffness, swelling, and impaired function. These conditions often arise from repetitive use, overuse, awkward hand positions, or underlying systemic conditions such as diabetes, rheumatoid arthritis, or hypothyroidism.


Two of the most common forms of tendinopathy in the upper limb are trigger finger and De Quervain’s tenosynovitis. In most cases, non-surgical treatment such as rest, splinting, physiotherapy, or corticosteroid injections is initially attempted. However, when these measures fail, surgery provides long-lasting relief.

Common types of tendinopathies treated surgically

  • Trigger finger This occurs when inflammation narrows the sheath around a flexor tendon, causing it to catch or lock in a bent position. Surgical release of the pulley at the base of the finger allows the tendon to glide freely again.
  • De Quervain’s tenosynovitis This condition affects the tendons on the thumb side of the wrist. Patients often report pain with gripping, lifting, or twisting movements. Surgical decompression of the first dorsal compartment alleviates pressure and restores function.
  • Other tendon injuries Chronic overuse or trauma can lead to tendon degeneration, partial tears, or ruptures that may require surgical debridement, repair, or reconstruction.

FAQ

1When is surgery indicated for tendinopathy?
If symptoms persist beyond 6–12 weeks despite conservative treatment, or if daily function is significantly impaired, surgical intervention is considered.
2What is the procedure and recovery like?
Most surgeries are short, outpatient procedures performed under local anaesthetic. Patients usually resume light hand use within a few days, with full recovery over a few weeks. Hand therapy may be recommended to optimise results.
3What are the expected outcomes?
Surgical treatment for tendinopathies has a high success rate. Most patients experience complete relief of symptoms, improved movement, and restored function with minimal recurrence.
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Dr Phalafala's success lies in her collaborative, detail-oriented approach to complex surgery. She develops personalised treatment plans focused on each patient’s unique needs, supported by a foundation of empathy, communication, and clinical excellence. Her goal is to provide transformative outcomes through reconstructive and cosmetic surgery that not only enhance form and function but also restore confidence and quality of life.

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