Trigger finger release

What is trigger finger? 

Trigger finger is a common condition where your finger or thumb catches or locks as it bends towards your palm. This can cause discomfort, clicking sensations and stiffness. Sometimes, small lumps will appear at the base of your finger or thumb.

The tendons that bend your fingers usually glide freely through tight tunnels made by flexor tendon pulleys attached to bones in your hand. If the wall of a tunnel thickens, the tunnel becomes too tight and your finger will remain in a bent position. Over time, the tendon will become inflamed and a lump (nodule) can form.

The causes are still generally unknown, but certain conditions such as gout, rheumatoid arthritis and diabetes can be a contributing factor. Women and those over 40 are also more likely to develop the condition.

What happens during trigger finger release?

There are two types of trigger finger release surgery. The type of surgery you need will depend on your condition, and your consultant will discuss this with you. Both procedures take around 20 minutes and normally use a local anaesthetic.

1. Open trigger finger release surgery

During open surgery, your consultant will make a small incision (cut) on the palm of your hand, near the base of the affected finger. They will cut open the root of the fibrous tunnel that is causing the trigger finger. This will allow the tendon to glide freely through the tunnel. Your surgeon will close your skin with stitches. Your surgeon may use a tourniquet (tight strap) to reduce bleeding. This helps your surgeon to see important structures such as nerves during the operation.

You may have a scar after this operation. However, the scar usually becomes almost invisible over time.

2. Percutaneous trigger finger surgery

During percutaneous surgery, your consultant will insert a needle into the base of your affected thumb or finger to slice the ligament to reach the tendon causing the problem. This type of surgery doesn’t require any incisions, leaving no scarring or wounds behind.

Preparing for trigger finger release

If you smoke, you should stop as soon as possible to reduce the risk of developing complications and improve your long-term health.

Recovery from trigger finger release

After the operation, you will be transferred to the recovery area and then to the ward. You will have a bandage on your hand and may need to wear a sling. You should be able to move your finger immediately after surgery, but it may be sore or tender. Full movement should return within a fortnight.

You should be able to go home the same day, but your doctor may recommend that you stay longer. If you have sedation or general anaesthetic, a responsible adult should take you home in a car or taxi and stay with you for at least 24 hours.

Recovering at home

• Do not drive, cook or operate machinery for at least 24 hours and not until you have fully recovered feeling, movement and coordination. Your surgeon will tell you when you can return to normal activities.
• Do not put on any rings until any swelling has settled.
• Keep your hand raised and bandaged for 2 days. It is important to gently exercise your fingers, elbow and shoulder to prevent stiffness.

Complications of trigger finger release

• Numbness in your finger caused by nerve damage. This can be permanent but the risk is less than 1 in 100.
• Tenderness of the scar.
• Bowstringing. This happens if important pulleys have been released as this causes the tendon to move away from the bone. This stops you from being able to fully straighten your finger. You may need another operation.
• Severe pain, stiffness and loss of use of your hand (complex regional pain syndrome - CRPS). The cause of this is unknown. You may need further treatment including painkillers and physiotherapy. You may be able to reduce this risk by taking a vitamin C table every day for 6 weeks after the operation. Your consultant will be able to discuss this with you.
• Failure of the operation to improve the symptoms

General complications

• Bleeding during or after the operation.
• Infection of the wound - If you get a high temperature, notice pus in the wound or if the wound becomes sore, red and painful, please contact your consultant. Usually, a course of antibiotics and regular dressings will settle the infection.
• Allergic reaction to the equipment, material or medication. Please let your consultant know if you have any allergies or if you have reacted to any medications, tests or dressing in the past.

Alternatives to trigger finger release surgery

Simple stretching in the early stages can ease the symptoms. Non-steroidal tablets such as ibuprofen may also help.

A splint may be used at night to stop the finger from bending over.

A steroid injection around the base of your finger can help to treat the problem. However, you may need more than one injection.