Trigger Finger Surgery

What is trigger finger surgery?

Trigger finger surgery is performed on patients with trigger finger, also known as stenosing tenosynovitis. It is a condition where you experience pain or stiffness when straightening or bending the finger.

The condition is caused by swelling of the tendon lining in the hand. This lessens the gliding motion of the tendons, causing finger joint pain or a 'catching' feeling when you try to flex your finger. This condition may also cause the finger to become locked or stuck in a bent position.

How it works

Surgery is done to release the tendon from the sheath when it is causing pain or the finger becomes ‘locked’. The surgeon will make a small cut into the palm of the hand and release the tendon from the part of the sheath it was catching on.

You can expect to regain normal use of your hand upon recovery.

Why do you need trigger finger surgery?

Your surgeon will recommend a trigger finger surgery if:

• All other types of treatment have not worked to treat your condition.
• Your finger is locked or permanently stuck.
• You have diabetes. (Using non-surgical options such as steroids in people with diabetes may lead to increased blood sugar levels. Thus, surgically treating trigger finger may be recommended instead.)
• You have rheumatoid arthritis.
• Your condition worsens over time and makes you unable to grasp things.
• Your condition prevents you from performing daily tasks, work and hobbies.

What are the risks and complications of trigger finger surgery?

Trigger finger surgery is a safe procedure, with low risk of complications. However, like any other surgery, it carries a small risk.

Common trigger finger surgery complications include:

• Bowstringing
• Incomplete extension
• Nerve damage

Call your doctor or seek emergency care if you experience any of the following after the surgery:

• Change of colour of your hand or fingers
• Chest pain
• Coughing up blood
• Fever
• Heavy bleeding in the area of incision
• Inability to move fingers
• Increased pain, swelling, warmth or redness
• Loose stitches
• Numbness or tingling sensation in your hand or fingers
• Pain that does not improve after taking pain medicine
• Pus coming from the area of incision
• Swollen lymph nodes
• Trouble breathing or shortness of breath

How do you prepare for trigger finger surgery?

You need to prepare for the procedure by doing the following:

• Arrange for someone to accompany you for the surgery. You will be given anaesthesia and pain medication during the surgery. It is not advisable to go home on your own after the procedure.
• Follow your doctor's instructions regarding food and drink restrictions before your surgery.
• Let your doctor know about the medications and supplements you are currently taking. You may be asked to temporarily stop taking certain medications like blood thinners.
• Prepare the things you will need after surgery such as ice packs and medications. Do ask your doctor about what you need to prepare for your recovery.
• Avoid wearing nail polish. Do not apply lotion or perfumes before the surgery.
• Do not wear jewellery during the procedure. Do leave your valuables at home.

What can you expect in trigger finger surgery?

Trigger finger surgery is a minor procedure that can be performed as day surgery with local anaesthetic.

Estimated duration

The procedure typically takes less than an hour.

Before the procedure

A small flexible tube (IV) will be inserted into your vein to provide you with fluids and medicine during the procedure. You will also be given local anaesthesia to numb the area to be operated on.

During the procedure

Your doctor may perform either of these two types of trigger finger surgery:

• Open surgery. Your doctor will first make a half inch incision on your palm. After that, he or she will cut your tendon sheath, before closing the cut with stitches.
• Percutaneous release. An incision is not necessary in this procedure. Your doctor will first numb your palm, before inserting a needle into your skin. With the help of ultrasound imaging, the doctor will use the needle to break up the blocking tissue around the tendon sheath.

Care and recovery for trigger finger surgery

After the surgery, you will be asked to stay in the recovery room for about 1 - 2 hours before heading home. Your health condition will be monitored to make sure you are stable and comfortable.

Your hand, wrist, and finger will be well-bandaged. You should be able to move your finger right after surgery.

Your doctor will prescribe anti-inflammatory drugs for pain relief and to reduce inflammation.

Recovery period

You may experience the following after surgery:

• Numbness or a tingling sensation near incision area, which is normal
• Some minor pain and discomfort
• Soreness in your finger and entire hand, and some difficulty moving them for several days

Consult your doctor if your condition does not improve after a few days.

Caring for your hand

You can recover faster and relieve your post-surgery pain by doing the following.

For the first 2-3 days after surgery:

• Avoid getting your hand wet until you have your doctor’s approval. Cover your hand with plastic to keep the bandage dry.
• Place a cold pack or ice wrapped in thin cloth on your hand for about 10 - 20 minutes. Do this every 1 - 2 hours for the first 3 days after the surgery to prevent swelling.
• Prop up your hand on a pillow when you sit or lie down. Try to keep the hand above the level of your heart. This will help reduce swelling.

General care after surgery:

• Eat a balanced diet (there is no post-surgery diet restriction).
• Get enough rest and sleep.
• Take medicines as directed by your doctor. You need to complete the full course of your antibiotics.
• Keep your hands clean (do not use hydrogen peroxide or alcohol during cleaning).
• Change the bandage daily.
• Go for finger and hand therapy if required. This will help you regain the normal motion, strength and grip of your hand.
• Attend your medical check-ups after the surgery.

Follow-up

Your doctor will remove the stitches 1 – 2 weeks after the surgery. You may take several months to heal completely.

You may be required to do several hand exercises or undergo physical therapy if you still experience pain.

You may return to work a day after the surgery if your job does not require using the hand. Otherwise, you may need to take time off to rest for at least 6 weeks. Do check with your doctor to find out how much time you need to fully rest from work.