Trigger Finger Release Surgery

Overview

Trigger finger release is a surgical procedure to treat trigger finger (stenosing tenosynovitis) that has not responded to conservative treatment. The surgery involves cutting the A1 pulley at the base of the finger, which allows the flexor tendon to glide more freely and eliminates the catching or locking. The procedure can be performed using open or percutaneous techniques.

Indications

This procedure may be considered when:

• •Trigger finger not adequately relieved by corticosteroid injections
• •Persistent triggering, catching, or locking despite conservative treatment
• •Finger locked in a bent position that cannot be straightened
• •Recurrence after initial improvement with injection
• •Patient preference to avoid repeated injections
• •Severe symptoms affecting daily hand function

How It Works

The procedure typically involves several coordinated steps:

• •The procedure is typically performed under local anesthesia
• •Open technique: A small incision is made at the base of the finger in the palm
• •The A1 pulley is identified and carefully divided longitudinally
• •The tendon is inspected for nodules or other abnormalities
• •Percutaneous technique: A needle is inserted through the skin to cut the pulley
• •The surgeon verifies that the finger moves smoothly without triggering
• •For open surgery, the skin is closed with sutures and a light dressing applied
• •The finger is moved immediately to confirm successful release

Risks

As with any surgical procedure, potential risks include:

• •Incomplete release with persistent triggering
• •Bowstringing of the tendon (very rare)
• •Injury to the digital nerve causing numbness
• •Injury to the flexor tendon
• •Infection
• •Stiffness of the finger
• •Scar tenderness
• •Recurrence of triggering (uncommon)
• •Need for additional surgery

Recovery Expectations

Recovery follows a gradual progression:

• •The procedure is performed as outpatient surgery
• •Finger movement is encouraged immediately after surgery
• •Light dressing is worn for a few days
• •Sutures are removed around 10 to 14 days after surgery (for open technique)
• •Most patients return to light activities within days
• •Full hand activities may resume in 2 to 4 weeks
• •Physical or occupational therapy may be recommended for stiffness
• •Complete recovery typically occurs within a few weeks to months

Alternatives

Depending on individual circumstances, alternatives may include:

• •Splinting, particularly at night
• •NSAIDs for pain and inflammation
• •Corticosteroid injection into the tendon sheath
• •Rest and activity modification
• •Physical or occupational therapy for stretching exercises

Sources

• AAOS OrthoInfo – Trigger Finger
• Mayo Clinic – Trigger Finger Treatment