152019May

What Does Trigger Finger Surgery Entail?

Trigger finger is a common medical condition that can be treated with a low-risk surgical procedure.


“Trigger finger” is the common phrase for the medical condition known as “stenosing tenosynovitis.” Trigger finger causes patients to experience a locking or clicking feeling as the finger bends and straightens.


Medical conditions and biological factors have been linked to the prevalence of trigger finger, but it can be difficult to predict what activities exacerbate trigger finger. Luckily, there are multiple treatment and surgery options that can alleviate symptoms.


What is trigger finger?


Trigger finger is a condition that causes pain, stiffness, or a locking sensation when you bend and straighten your finger. This feeling most commonly affects the ring finger and the thumb, but it can occur in any finger. It’s caused when the sheath that protects the tendons within your fingers becomes inflamed, placing pressure on the tendon and making it difficult to move your finger normally.


Causes of trigger finger vary and can be attributed to a number of medical conditions and lifestyle factors. There’s no one specific cause of trigger finger, which makes it difficult to prevent or predict. Medical conditions such as rheumatoid arthritis, diabetes, and gout can lead to trigger finger inflammation – for example, the lifetime risk of experiencing trigger finger jumps to 10% for diabetics.


The condition is also more common in people over 50 and six times more common in women than men. While it’s difficult to correlate a specific career or lifestyle factor with trigger finger, it’s more common among “farmers, industrial workers, musicians, and anyone else who repeats finger and thumb movements.”


Trigger finger is relatively easy to diagnose. If you feel pain at the bottom of your finger or thumb when it moves, or experience a stiffness of clicking sound when moving your finger or thumb, that can be a sign of trigger finger. Other symptoms include loss of ability to bend or straighten the finger, or the digit may curl and get stuck before spasming straight suddenly.


Treatment and surgery for trigger finger


There are some surgical and nonsurgical ways to treat trigger finger symptoms. Before recommending surgery, your doctor may prescribe a non-steroidal anti-inflammatory (NSAID) to help bring down some of the pressure on your tendon. They may also suggest resting or splinting the affected finger to reduce movement. In more extreme cases, corticosteroid injections may be used to reduce swelling.


If no available nonsurgical options alleviate your pain, then there are three types of trigger finger surgical procedures available. The first, and most common, is open surgery. In this procedure, a surgeon makes a small cut into the palm, and cuts the tendon sheath around the tendon to give  the tendon more room to move. The entire operation is performed with a local anesthetic and is the preferred method by most doctors due to the low risk of complication.


The second type of surgery is percutaneous release surgery. In this procedure, the surgeon inserts a needle into the bottom of the finger to cut the tendon sheath. It’s less invasive than open surgery; there are no stitches needed as there is no open wound. The risk of using this method is that there may be damage to blood vessels or nerves close to the tendon sheath as the needle enters the digit.


Finally, for patients with rheumatoid arthritis, a procedure called tenosynovectomy is a good option. This slightly more invasive option removes a part of the tendon sheath altogether. This is usually the last option made available to patients, as it comes with the highest risk of complication.


Both percutaneous release surgery and open finger surgery take about 20 minutes and use a local anesthetic, making them very low risk procedures. Here’s what to expect when recovering from trigger finger surgery.


Recovering from trigger finger surgery


Following trigger finger surgery, patients can expect to feel some initial soreness in the palm of the hand. Doctors usually prescribe a painkiller for the first few weeks after the operation. Patients may feel numbness or tingling near the incision point, which should go away after a few days.


The finger will need to be dressed with bandages for four to five days; full movement will return after two weeks. Most people are able to drive after five days. Stitches, if present, will be removed after three weeks.


As with any surgery, patients should take care to rest, eat well, and avoid strenuous exercise following trigger finger surgery. Ice your hand as much as possible in the first days following the operation, and take care not to get your wound dressing wet in the shower. Overall, expect to wait three to six months for the swelling and stiffness to completely disappear. Luckily, success rates are high; patients who undergo trigger finger surgery are unlikely to see symptoms return in the future.


Are you considering trigger finger surgery? Florida Hand Center offers free hand screenings to help you understand the symptoms and best treatment options available for your unique issue. Consult with one of our hand specialists to learn what type of trigger finger surgery is right for you.