Trigger finger release is a minor operation done on the hand to treat a case of trigger finger, also called stenosing tenosynovitis. This is a painful condition that causes difficulty in moving the affected finger or thumb, which might snap or pop into an extended position, like releasing the trigger of a gun. In severe cases, the finger might lock into a bent position. The surgery is usually done under local anesthetic and does not require an overnight stay in the hospital.
This condition is most commonly caused by repetitive action, so it is seen frequently in people who work with their hands, such as musicians and industrial workers. It presents initially with pain at the base of the affected finger and is sometimes swollen. A clicking noise can often be heard when moving the finger. Movement of the finger tends to be especially painful if it hasn't been used for a period of time and lessens after it loosens up. Other causes are rheumatoid arthritis, gout and diabetes.
Tendons and muscles work together to allow free movement of the fingers. The tendons are surrounded by a sheath that allows smooth gliding. In the case of trigger finger, the tendon becomes thickened, which restricts the normal movement within the sheath. Continued forced movement of the finger might cause the inflamed portion to pop through the tendon sheath, causing a painful snap. A nodule is sometimes seen at the base of the finger.
Initial treatment of trigger finger is with splinting to limit activity and anti-inflammatory medicine. If there is no response, trigger finger release surgery is performed. This is usually done under local anesthetic — just the hand is made numb, and the patient remains awake throughout the surgery. In some cases, regional or general anesthetics might be performed, but this is unusual.
During the procedure, a small incision is made at the base of the affected finger. The surgeon will then release the tendon by making a small cut in the tendon sheath. The patient might be asked to move his or her fingers so that the surgeon can be sure that the affected finger has been released completely. This will not hurt, because of the anesthetic. The incision will be stitched up and bandaged.
After trigger finger release, short-term painkillers might be necessary. To minimize swelling, the hand should be kept elevated when possible, and the fingers and thumb should be gently moved regularly to prevent stiffness. The stitches and dressings will be removed a week or two after surgery. Some patients see a physical therapist after trigger finger release surgery to help them regain full function of their hand.
