Trigger Release Surgery

What is Trigger Thumb?

Trigger finger, also known as stenosing tenosynovitis or flexor tendonitis, is a condition where one of the fingers or thumb of the hand is caught in a bent position. The affected digit may straighten with a quick snap, similar to pulling and releasing the trigger on a gun, hence the name trigger finger.

Symptoms of Trigger Thumb

Commonly reported symptoms associated with trigger finger include the following:

• Bent finger suddenly pops out and straightens
• Finger movement creates a “popping” or “clicking” sound or sensation
• Finger feels stiff and sore
• Finger becomes bent with inability to straighten

Symptoms are worse in the morning.

Treatment for Trigger Thumb

Your surgeon will recommend conservative treatment options to treat the trigger finger symptoms. Treatment options will vary depending on the severity of the condition.

Indications for Trigger Release Surgery

Your surgeon may recommend percutaneous trigger release surgical procedure to release the tendon in the following cases:

• Conservative treatment options fail to resolve the condition
• Symptoms persist for 6 months or more
• Your quality of life is adversely affected

Trigger Release Surgery Procedure

This surgery is usually performed in an operating room under local or regional anesthesia, on an outpatient basis as day surgery. Your surgeon makes one small incision, about inch long, to the affected finger area. Your surgeon then releases the tight portion of the flexor tendon sheath. The incision is then closed with a couple of sutures and covered with a sterile dressing.

Postoperative Care for Trigger Release Surgery

After surgery, your surgeon will give you guidelines to follow. Common postoperative guidelines include:

• Keep the surgical incision clean and dry. Cover the area with plastic wrap when bathing or showering.
• Ice packs to the surgical area may be used to reduce pain and swelling.
• The bandage is usually removed after a couple days.
• Once the bandage is removed, full movement of the finger is encouraged.
• Eating a healthy diet and not smoking will promote healing

Risks and Complications of Trigger Release Surgery

As with any major surgery, there are potential risks involved. The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages. It is important that you are informed of these risks before the surgery takes place.

Complications can be medical (general) or specific to hand surgery. Medical complications include those of the anesthetic and your general wellbeing. Almost any medical condition can occur, so this list is not complete.

• Allergic reaction to medications
• Blood loss requiring transfusion with its low risk of disease transmission
• Heart attack, strokes, kidney failure, pneumonia, bladder infections
• Complications from nerve blocks such as infection or nerve damage
• Serious medical problems can lead to on-going health concerns, prolonged hospitalization, or sometimes death
• The majority of patients suffer no complications following trigger finger surgery; however, complications can occur and include:
• Infection
• Nerve damage causing weakness, paralysis, or loss of feeling in the hand area
• Stiffness to the finger
• Trigger thumb returns if the sheath is not adequately released

Risk factors that can negatively affect adequate healing after surgery include:

• Poor nutrition
• Smoking
• Alcoholism
• Chronic illness
• Steroid use
• Age (over 60)