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.
About Trigger Finger Release 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.
Diagnosis of Trigger Finger
Your doctor 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 doctor 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.
What are the Alternatives to Trigger Finger Release Surgery?
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.
About the Operation
You will usually be given an injection of local anaesthetic into the palm of your hand.
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.
What to expect after the Trigger Finger Surgery?
After a local 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 anaesthetic, you will usually be able to go home when you feel ready. It is done in a day surgery setting.
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 14 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.
Recovering From Treatment
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.
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.
What are the Risks?
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.
Trigger Finger Release Specialist
Dr Chee Kin Ghee is a Hand Specialist Surgeon at Singapore Sports & Orthopaedic Clinic. His interest is Trigger Finger Release Surgery.