Trigger Finger Release

About Trigger Finger Release

Trigger finger release is a short operation for stenosing tenosynovitis, a condition in which a thickened flexor tendon and tight tendon sheath cause a finger or thumb to catch, click or lock in a bent position. The narrowing occurs at the A1 pulley, a band of fibrous tissue at the base of the digit. Trigger finger is more common in people with diabetes and rheumatoid arthritis and in middle aged women. Nonsurgical options include activity modification, splinting and corticosteroid injection into the tendon sheath, which is effective for many people, although its effect is less consistent in people with diabetes. Surgery is generally considered when triggering persists or recurs. In open release, a small incision is made in the palm at the base of the affected digit under local anesthesia, often with the patient awake and without a tourniquet, which allows the surgeon to confirm smooth tendon gliding by asking the patient to move the finger. The A1 pulley is divided while the digital nerves on either side are protected. Percutaneous release divides the pulley with a needle tip without an open incision. Results are generally very good, with relief of catching usually immediate. Complications are uncommon and include injury to a digital nerve, infection, persistent stiffness and bowstringing of the tendon if more distal pulleys are damaged. Recurrence after surgery is uncommon. In young children, a congenital form of trigger thumb is managed differently.