Trigger Finger Release

1. A steroid injection in the palm can be given in our Outpatient clinic. This cures a significant proportion of cases (up to 70%).
2. Surgery is highly effective, and the triggering is cured immediately. Significant problems after the operation are very rare. Most people are almost back to normal within three weeks.

• Very rarely the operation fails (less than 1%) and may need to be repeated with a more extensive release.
• Recurrence is unusual although some people have a tendency to develop trigger fingers and may develop another elsewhere.
• Very occasionally a nerve running to the finger can be injured during the operation, resulting in numbness on one side of the finger.

With planned operations complications are unusual. Statistically about 5% of patients have a post-operative problem, the vast majority of which are temporary and do not affect the final result.

Infection. The signs may develop after a few days, with increasing pain, swelling and redness. Treatment with antibiotics is usually sufficient. Very occasionally an infection can be severe and cause major problems.

Wound healing problems. Excessive bleeding, causing a painful swollen wound (haematoma) or delayed healing may slow down the recovery. A few people react to the dissolving suture material, and this can lead to localised areas of tenderness and swelling that persist for a couple of months.

Swelling and stiffness. It is very important to elevate and exercise the hand after an operation or injury. Occasionally the swelling is severe, prolonged and associated with pain, due to the development of the poorly understood condition called complex regional pain syndrome (CRPS). This can be treated with physiotherapy and pain tablets. Very rarely it leads to long-term stiffness and disability, compromising the function of the hand permanently.

All rings on the hand must be removed before hand surgery.

The operation is usually done under local anaesthetic as a day case. The consultant will make an incision in the palm at the base of the affected finger or thumb. The opening in the tunnel is cut, so it becomes shaped like a funnel, allowing the tendon to glide in and out smoothly. The incision will be closed with dissolving stitches and the wound is dressed, leaving the fingers and thumb relatively free to move.

The hand must be elevated for 48 hours when still but should be moved and used as normally as possible.

Any pain after the operation usually settles if the hand is kept elevated. Painkillers may be needed for the first few days. Physiotherapy is not usually needed, though the finger often feels stiff for a couple of months.

The dressings can come off after about five days, keep the wound clean and dry for 14 days.

Any knots from the dissolving stitches should be rubbed off after two weeks when washing.

The scar will remain tender for at least two months, and it should be massaged with cream (lanolin, E45, Double Base) regularly. In about 10% of people the scar, after healing well initially, thickens and becomes itchy, red and more painful after the first month. If this happens the scar settling down to normal, thin, mobile skin can take more than a year.

Ability to drive after the procedure varies from person to person. It is up to you to decide when you feel comfortable to do so. It will probably be less than a week if the right hand is operated on, but it may be longer for the left because of the need to use the hand brake.

Manual workers normally need about three weeks off work, but office employees will be able to return sooner.

Signs of wound infection may develop after a few days, with increasing pain, swelling and redness. Seek advice from your GP as treatment with antibiotics is usually sufficient.