Trigger Finger is a common name for inflammation in one of the flexor muscle tendons of the fingers. Inflammation leads to shortening and stretching of the tendon (Stenosing tenosynovitis), and finally to bending of the finger, usually the thumb or forefinger, to stiffness and pain.
Trigger Finger repair surgery is done in order to allow the finger to bend and straighten again without causing pain.
When is it important to have surgery?
The reason for the development of the trigger finger is not yet fully clear, but is probably related to overactivity of the fingers. It has also been found that people with illnesses like rheumatoid arthritis and diabetes are at increased risk for developing this condition.
In most cases the thin finger is not a serious disorder but without proper treatment the finger may remain fixed in a bent position and cause disability and permanent dysfunction.
There are a number of conservative treatments for trigger finger and if these treatments fail and the trigger finger impairs daily functioning, the injury can be resolved through surgery.
The decision to have surgery will be made in collaboration with the surgeon and will depend on the degree of pain the patient is experiencing, the degree of disruption to routine daily functioning, and dependence on other existing medical conditions, such as diabetes.
The course of the surgery
The operation lasts about half an hour, is performed under local anesthesia and the patient can be discharged home the same day.
There are two approaches to trigger finger surgery.
The first approach being an "open" approach, in which a small incision is made in the palm to release the injured tendon. The incision is then sutured and bandaged.
The second approach is a percutaneous approach in which a needle is inserted through the skin in order to release the tendon sheath. Although this approach is less invasive it is slightly more prone to complications and may be less effective, so in most of the world there is a preference for open surgery.
What are the possible complications of this surgery?
After surgery, an infection, pain or stiffness of the finger can develop. Occasionally there may be damage to the nerves of the finger or scaring pain. Before surgery, it is important to discuss in detail the possible complications and how to avoid them, with the surgeon.
Recovery from surgery
The operated finger can be fully moved already on the day of surgery, and several days after surgery, with decreased pain, the bandages can also be removed. In order to reduce the swelling in the area of the operation, some surgeons will recommend occupational therapy or hand palm exercises.
Recovery and swelling can sometimes take up to six months after open surgery, whereas after surgery with a percutaneous approach the recovery is usually faster. Recovery may be delayed if more than one finger is operated on.
Return to routine should be adapted to the activities performed daily and at work.
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