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Trigger finger release surgery

Key points

  • You will usually only need surgery for trigger finger if other treatments haven't worked.
  • There are two main types of operation to treat trigger finger: percutaneous trigger finger release surgery and open surgery.
  • Trigger finger release surgery is usually done as a day-case procedure under local anaesthesia.
  • It usually takes about three to four weeks to make a full recovery from trigger finger release surgery.

Trigger finger (stenosing tenosynovitis) is a condition in which your finger or thumb clicks or gets stuck when you make a fist. Trigger finger release surgery involves dividing a ligament at the base of your finger to release the inflamed tendon causing your trigger finger. This allows the tendon to move freely.

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.

About trigger finger release surgery

There are two main types of operation to treat trigger finger: percutaneous trigger finger release surgery and open surgery.

In open surgery, your surgeon makes a small cut in the palm of your hand to reach your tendon and divide the ligament. In percutaneous trigger finger release surgery, your surgeon will use a needle to divide the ligament and release the tendon. Percutaneous trigger finger release isn't a suitable treatment for everyone. Ask your doctor if it’s suitable for you.

What are the alternatives to trigger finger release surgery?

If you have mild trigger finger, it may get better without treatment. However, if it doesn't get better within a few weeks, you may want to consider treatment. Splinting isn't usually helpful if you have had trigger finger for a long time, but it may help if you have mild trigger finger.

Trigger finger can be treated with an injection of a steroid around the inflamed area of the tendon, in the palm of your hand.

However, if your finger or thumb is permanently locked or previous steroid injections haven’t worked, you may want to consider surgery. You will usually only need surgery if other treatments haven't worked or if the condition returns after being initially treated successfully with steroid injections.

Preparing for trigger finger release surgery

Your surgeon will explain how to prepare for your operation. For example, if you smoke, you will be asked to stop. Smoking increases your risk of getting a chest and wound infection, which can slow your recovery.

Trigger finger release surgery is usually done as a day-case procedure under local anaesthesia. This completely blocks pain from your hand and you will stay awake during the operation. It's sometimes done under regional or general anaesthesia instead. If you have a regional anaesthetic, your entire arm will be numb and you will stay awake. If you have a general anaesthetic, this means 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.

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. 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. You may be asked to do this by signing a consent form.

What happens during trigger finger release surgery?

Trigger finger release surgery usually takes around 20 minutes. There are two main methods of surgery.

Open surgery

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 dividing the ligament where the tendon is catching.

Once your surgeon has released the tendon, he or she may ask you to flex your fingers. This is to check that the tendon is completely released before your surgeon closes the cut.

Once the procedure is finished, your surgeon will close the cut in the palm of your hand with stitches. He or she will put a dressing on your hand to cover the wound.

Percutaneous trigger finger release surgery

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 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.

What to expect afterwards

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 your hand. 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.

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 after your operation.

General anaesthesia temporarily affects your co-ordination and reasoning skills. This means 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. You may be given a date for a follow-up appointment.

Your stitches will be removed about 10 days after your operation. Try to keep your dressing and wound dry until the stitches are removed. If you have dissolvable stitches, the amount of time they will take to disappear will depend on the type of stitches you have. However, for this procedure, they should usually disappear in around two to three weeks.

Recovering from trigger finger release surgery

Most people are able to resume light manual activities within a few days of their surgery. It usually takes about three to four weeks to make a full recovery from trigger finger release surgery. However, this varies between individuals, so it's important to follow your surgeon's advice.

Try to keep your hand above the level of your heart 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 over-the-counter painkillers, such as paracetamol or 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 should be able to start moving your finger soon after surgery, when it’s comfortable to do so. Follow your surgeon's advice about returning to work.

If you're struggling to regain normal use of your hand after three to four weeks, you may need to have hand therapy. However, this isn't usually necessary.

You might feel some tenderness, discomfort and swelling around the site of the procedure for a few weeks afterwards. Contact your hospital or GP if:

  • your wound becomes red, swollen or hot
  • your wound smells unpleasant or oozes liquid
  • you develop a temperature
  • your fingers become progressively more swollen or stiff

What are the risks?

As with every procedure, there are some risks associated with trigger finger release surgery. 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

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 in your hand. This may last for several weeks.

Complications

Complications are when problems occur during or after the operation. Complications of trigger finger release surgery include:

  • damage to the nerves or blood vessels in your finger
  • an infection in your tendon sheath or wound, particularly if you have diabetes or if your immune system isn't working as it should
  • swelling and stiffness in your finger or thumb after the operation
  • restricted movement in your finger (not being able to bend and straighten it fully)
  • a tender scar in the long term

 

Reviewed by Rachael Mayfield-Blake, Bupa Health Information Team, September 2013.

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For answers to frequently asked questions on this topic, see FAQs.

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.

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