Trigger Finger Release
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What’s the Problem?
Trigger finger occurs when the tendons which flex the fingers get stuck. Usually, this occurs underneath one of the pulleys that allows for normal tendon glide. It results in the finger getting stuck or triggering. It can present as either painful or pain free. It is more common in patients with diabetes.
How can you treat it?
In some instances, non-surgical treatment is appropriate. This includes hand therapy exercises and injections – generally a steroid injection into the area where the tendon is getting stuck. Surgery is usually reserved for cases which do not improve with injections.
The Operation
A trigger finger release involves a small incision over the taut pulley, and releasing it to allow smooth finger motion. The finger is then dressed and no plaster is required.
The Anaesthetic
If you wish, you can be asleep for the entire operation. However, most patients choose light sedation and local anaesthetic as it leads to a quicker recovery from the anaesthetic. You will not feel any pain with the incision as the local anaesthetic will dull the nerves to the area.
What are the Risks of this Operation?
- Infection:
Usually only a superficial wound infection to the top-most layer of the skin. In rarer cases a deep infection can develop and this is a serious complication that may require further surgery. Rare but serious, <1%. - Injury to the small arteries and nerves:
These structures are small and need to be protected during the dissection. Rare but serious <1%. - Stiffness: sometimes can occur after tendon surgery because of the development of scar tissue. Generally resolves with hand therapy.
- Complex Regional Pain Syndrome (CRPS):
This is a chronic pain response that develops after an insult (like trauma or surgery) which we don’t have a full understanding of. It usually presents as ongoing burning or stinging to the hand, with change in sensation as well. Some factors increase the risk of developing this such as injury to the hands or feet, middle age and female gender. Mr Lau routinely prescribes Vitamin C post operatively, which has been shown in some studies to reduce the development of CRPS, but if it does develop, then a prolonged rehabilitation with hand therapy may be required.
Benefits
If Mr Lau recommends an open trigger finger release, it is because he feels you will have a better outcome with surgery. The main focus of surgery is to correct the triggering of the finger.
What can I expect?
After surgery, your hand will be bandaged in bulky dressings. You will have had local anaesthetic to the area which takes 24-48 hours to wear off entirely. The nurses will provide you pain relief in the recovery area.
Most patients recover reasonably quickly and are able to have their surgery as a day stay procedure. You will be discharged with pain medication and early Hand Therapy appointments will be made for you within the first 3-5 days. Mr Lau will then see you again around 6-8 weeks after surgery.
What should I avoid doing?
- In the first 2 weeks: keep your wound dry. Try to mobilise your fingers and elbow as much as possible.
- Once the wound has healed, there are no further restrictions
Return to…?
- Work: depends what you do. Desk based work can be done from ~10 days post operatively, if you can do these tasks single handedly.
- Drive:in Australia, you can’t drive unless you are in full control of both your arms. Therefore, whilst your hand is bandaged you cannot drive.
- Sports/Hobbies: No restrictions after 10 days if the wound has healed
Concerns or questions?
If you have any concerns post operatively, or you would like further information, please contact Mr Lau through the VBJS on 03 5752 5020 or via email at admin@vbjs.com.au
If you need urgent medical help, call 000 or go to your nearest emergency department.
Rehabilitation protocol
These notes have been prepared by Mr Simon Lau. They are general overviews and information aimed for use by his patients. They reflect Mr Lau’s views, opinions and recommendations. They do not constitute medical advice. The contents are provided for information and education purposes only. Please seek Mr Lau’s specific advice with any questions regarding medical conditions and treatment.