Published by Bupa's Health Information Team, July 2011.
This factsheet is for people who are having surgery to treat trigger finger, or who would like information about it.
Trigger finger (stenosing tenosynovitis) is a condition where the finger or thumb clicks or gets locked in place, when it’s bent towards the palm. Trigger finger release surgery involves dividing a ligament (called a pulley) to release the inflamed tendon.
You will meet the surgeon carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.
There are two main types of operation to treat trigger finger: percutaneous trigger finger release surgery and open surgery.
If you have open surgery, your surgeon will make a small cut into the palm of your hand at the base of your affected finger, and then release the tendon from the ligament (A1 pulley) that it is catching on.
If you have percutaneous trigger finger release surgery, your surgeon will insert a needle into the base of your affected finger and use this to divide the pulley, releasing the tendon.
Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history. Trigger finger is more common in people with diabetes and people with rheumatoid arthritis.
Your GP will examine your hand by asking you to make a fist then straighten your finger or thumb. If your finger or thumb get stuck or clicks, he or she will be able to diagnose trigger finger. He or she may also examine your hand for a nodule (bump) in your palm at the base of your affected finger.
Trigger finger can be treated with an injection of a steroid around the inflamed area of the tendon. However, if your finger or thumb is permanently locked, previous steroid injections haven’t worked, or if you keep getting trigger finger, surgery will be considered.
Occasionally, using a splint to keep your finger straight can help. However, it may take several weeks before it has any effect.
You will usually only need surgery if other forms of treatment haven't worked or if you have developed trigger finger as a result of rheumatoid arthritis.
Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.
Your surgeon will explain how to prepare for your operation. For example if you smoke you will be asked to stop, as smoking increases your risk of getting a chest and wound infection, which can slow your recovery.
The operation is usually done under local anaesthesia. This means you will be awake, but your hand will be numb. It's sometimes done under regional or general anaesthesia instead. If you have a regional anaesthetic, your entire arm will be numb, but you will stay awake. If you have a general anaesthetic, you will be asleep during the procedure.
If you're having a general anaesthetic, you will be asked to follow fasting instructions. This means not eating or drinking, typically for about six hours beforehand. However, it’s important to follow your surgeon’s advice.
You will usually be given an injection of local anaesthetic into the palm of your hand. If you have a regional anaesthetic, it will be injected under your armpit. If you have a general anaesthetic, it may be injected into a vein in your arm or the back or your hand, or you may breathe it in through a mask.
After the anaesthetic has taken effect, your surgeon will make a small cut in the palm of your hand to get to the tendon. He or she will then release the tendon by making a cut into the tendon sheath that surrounds it.
Once the tendon has been released, you may be asked to move your fingers and make a fist. This won't hurt. Your surgeon may ask you to do this to check that the tendon is completely released before he or she closes the incision.
Once the procedure is finished, your surgeon will close the cut in the palm of your hand with stitches and put a dressing on your hand to cover the wound.
After the anaesthetic has taken effect, your surgeon will insert a needle into the base of your affected finger. He or she will use the needle to divide the ligament (the A1 pulley) that is restricting the tendon. Your surgeon will then remove the needle. As percutaneous surgery doesn’t require your surgeon to make a cut, you won’t have a wound and won’t need any stitches.
After a local or regional anaesthetic it may take several hours before the feeling comes back into your hand. Take special care not to bump or knock the area. If you had the operation under general anaesthesia, you may need to rest until the effects of the anaesthetic have passed.
You may need pain relief to help with any discomfort as the anaesthetic wears off.
If you had a local or regional anaesthetic, you will usually be able to go home when you feel ready. If you had a general anaesthetic, you will need to arrange for someone to drive you home. Try to have a friend or relative stay with you for the first 24 hours.
General anaesthesia temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you're in any doubt about driving, contact your motor insurer so that you're aware of their recommendations, and always follow your surgeon's advice.
Your nurse will give you some advice about caring for your healing wound before you go home and you may be given a date for a follow-up appointment.
Your stitches will be removed about 10 days after your operation. You will need to keep your dressing and wound dry until the stitches have been removed. If you have dissolvable stitches, the amount of time they will take to disappear depends on the type of stitches you have. However, for this procedure, they should usually disappear in around two to three weeks.
It usually takes about three to four weeks to make a full recovery from trigger finger release surgery, but this varies between individuals, so it's important to follow your surgeon's advice.
Try to keep your hand above waist level during the first few days after the operation. This will help to reduce any pain and swelling. It's important to move your fingers and thumb regularly, so they don't become stiff.
If you need pain relief, you can take an over-the-counter anti-inflammatory painkiller, such as ibuprofen. This will help relieve any pain and swelling in your hand. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.
Try to resume your usual activities as much as possible. You will usually be able to start moving your finger soon after surgery, when it’s comfortable to do so.
If you are struggling to regain normal use of the hand after about three weeks, you may need to have some hand therapy. Your surgeon will be able to arrange this.
Some people feel tenderness, discomfort and swelling around the area of their scar for a while after the operation (if they have had open surgery). Contact the hospital or your GP if:
As with every procedure, there are some risks associated with surgery to release trigger finger. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your surgeon to explain how these risks apply to you.
Side-effects are the unwanted but mostly temporary effects you may get after having the procedure.
After surgery, you may have some pain, tenderness and swelling around the operation site. This may last for several weeks.
Complications are when problems occur during or after the operation. Complications of trigger finger release surgery include:
For answers to frequently asked questions on this topic, see Common questions.
For sources and links to further information, see Resources.
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This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.
Publication date: July 2011
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