trigger finger redux

Last fall I made inquires about trigger finger on this board, and got
some very helpful and interested replies. I thought I'd bring those
interested up to date on my fencer's story in case it may help
somebody else in the future. To recap:

Our cadet epee fencer developed an extremely painful condition on the
ring finger of his weapon hand, with 2 different diagnoses. One MD
said it was trigger finger, another a ganglion cyst. Well, they were
both sort of right, and a variety of treatments were tried, including
anti-inflammatories, steroid shots, a brace for the night time, as
well as holistic stuff like massage, ice, etc.

We finally were forced to consult a hand surgeon (ortho type) who
could find no mass or note no triggering (this was after a 6 week
hiatus). We consulted another who found the trggering, and referred
the fencer to a hand plastic surgeon. He noted both issues, scheduled
surgery, and operated. Upon his initial look-see, he found remnants
of a burst cyst, synovial thickening and damage due to the triggering
as well as damage due to the steroid shots in September. He cut the
A-1 pulley in the hand itself, debrided the remnants of the cyst and
earlier steroid injections, and trimmed the synovial sheath, but did
not cut into it at the critical # 2 pulley in the finger. He bathed
the area in Kenalog, and closed the very cool "w" shaped incision
(made to minimize pulling by developing scar tissue). Follow up care
has been excellent, with the surgeon insisting on exercises and ice
after training, and massage 5-6 times a day to prevent keloids.
Although full function has not yet returned, our fencer can at least
take parries again! In addition, changing grips from a visconti to a
Russian seems to help, and extra padding has been added to the glove
in critical areas.

I guess my big recommendation after this experience is if you are a
fencer experiencing trigger finger on your dominant hand, see a hand
plastic surgeon rather than a orthopedic hand surgeon (who is in sync
with the athlete thing), and do experiment with a variety of grips
after recovery. It is worth the expense.

Thanks again for all your ideas and sympathy last fall. They were
invaluable in deciding how to proceed.