Trigger finger release is a relatively quick and straightforward procedure. It may be carried out under a general anaesthetic or local anaesthetic with sedation. This will depend upon your preference and also any other health risks that you may have. The anaesthetist will discuss which option is so most appropriate.
Procedure
The surgery is performed using a tourniquet. This stops any blood flow into the arm and provides a dry operating zone.
A small transverse incision is made at the base of the affected finger.
The procedure involves the release of the A1 Pulley. This is a thin strip of tissue that the flexor tendon travels underneath. If the flexor tendon has become thickened, it tends to catch as it passes under the pulley. The pulley is divided and this allows the tendon to travel freely. There are five pulleys further along the length of the finger. Only the first pulley is released.
The wound is closed with sutures and a dressing is applied.
Post-operative Care
Most patients can be discharged a few hours later. The hand is kept elevated as much as possible for the first few days to prevent swelling. The wounds are kept clean and dry until review. Sutures are removed two weeks after surgery. At that stage patients can get their wound wet and start washing their hands normally.
The mechanical problem with triggering and catching disappears as soon as the A1 pulley is released. Nevertheless, patients may have discomfort around the area of surgery due to some ongoing inflammation which will linger. This may cause some tenderness when patients grip or put pressure across this area for the first month or two.