Trigger finger is a common problem that causes pain and snapping of the tendons in the fingers. The problem that occurs in a patient who has trigger finger is due to the tendons of the fingers, and the sheath in which these tendons live.

The tendons in your fingers are like ropes that attach to the ends of your fingers. When your forearm muscle contracts, the tendons pull the fingers into a fist. The tendons run part of their course through a sheath called the flexor tendon sheath. In patients who have a trigger finger, this mechanism of movement is not smooth.

The cause of trigger finger is unclear, and can seemingly appear from nowhere. It can occur in one or more fingers, and can occur at different times in different locations. Trigger finger results from a discrepancy between the size of the tendon and the entrance to the tendon sheath. This discrepancy can be the result of localized inflammation or a nodular swelling on the tendon itself.

When the size discrepancy between the tendon and the tendon sheath reaches a critical point, the tendon will experience resistance from the tendon sheath. At first, this is experienced as a snapping of the trigger finger when relaxing a fist. If the condition worsens, the trigger finger may need active force from other fingers to straighten, or may not straighten at all.

The name trigger finger is from the symptom of triggering or snapping. This occurs when relaxing a fist, the affected trigger finger remains flexed. When enough force has been gathered, the trigger finger will suddenly extend, like pulling a trigger.

Trigger Finger Surgery Candidates

If you have symptoms of trigger finger, your GP will look at your hand and feel the affected finger. He or she may be able to feel a nodule (bump) in your tendon. Your GP may ask you to bend and straighten your fingers while he or she feels your palm, as this is where the catching of the tendon happens.

Trigger Finger Surgery Alternatives

If the problem does not resolve, a surgery to release the tendon may be necessary. This procedure is a same day surgery that can be done under local anesthetic or regional nerve block. A small (less than 2 cm) incision is made in the skin, and the tight portion of the flexor tendon sheath is released.

Following the procedure, a sterile bandage is applied to the site of surgery. This bandage is removed after a few days, and full use of the finger may then begin. Activity of the finger is encouraged as this will help prevent new adhesions (scar) from forming where the surgery was performed. Full recovery is expected for surgery.

Trigger Finger Surgery Outcome & Benifits

Once surgery has been performed the condition rarely comes back to haunt patients.

Prepare for Trigger Finger Surgery

Your surgeon will explain how to prepare for your operation. For example, if you smoke, you may be asked to stop as smoking increases your risk of getting a wound infection, which can slow your recovery.

The operation is usually done under local anaesthesia. This means you will be awake, but your hand will be numb. It's sometimes done under regional or general anaesthesia instead. If you have a regional anaesthetic, your entire arm will be numb, but you will stay awake. If you have a general anaesthetic you will be asleep during the procedure.

If you're having a local or regional anaesthetic there is usually no need to go without food or drink. If you're having a general anaesthetic, you will be asked to follow fasting instructions. Typically, you must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand.

At the hospital your nurse may check your heart rate and blood pressure, and test your urine.

Your surgeon will usually ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.

Trigger Finger Surgery Overview

You will usually be given an injection of local anaesthetic into the palm of your hand. If you have a regional anaesthetic, it will be injected under your armpit. If you have a general anaesthetic, it may be injected into a vein in your arm or the back or your hand, or you may breathe it in through a mask.

Your surgeon may wrap a tourniquet around your arm to temporarily reduce the blood flow to your hand during the operation.

After the anaesthetic has taken effect, your surgeon will make a small cut in the palm of your hand to get to the tendon. He or she will then release the tendon by making a cut into the tendon sheath that surrounds it.

Once the tendon has been released, you may be asked to move your fingers and make a fist. This won't hurt. Your surgeon may ask you to do this to check that the tendon is completely released before he or she closes the incision.

Once the procedure is finished, the cut in the palm of your hand will be closed with stitches.

Trigger Finger Recovery

A successful ankle replacement will get rid of your pain and allow you to move your ankle to up and down. Usually, total ankle replacements last 10 or more years. How long yours lasts will depend on your activity level, overall health, and the amount of damage to your ankle joint before surgery.

After surgery, you will need to stay in the hospital for up to 4 days. When your surgery is complete, your leg will be elevated and your ankle immobilized in a splint.

A small tube that helps drain blood from the ankle joint will be left in your ankle for 1 or 2 days. To keep swelling down, you can keep your foot raised higher than your heart while you are sleeping or resting.

Your doctor may recommend physical therapy to learn exercises that will help with ankle motion.

Trigger Finger After Care

You will have a dressing put on your hand to cover the wound. This will need to stay in place for around 10 to 14 days after the operation.

If your hand feels sore, you may need to take some painkillers. Please discuss any discomfort with your nurse.

If you had a local or regional anaesthetic, you will usually be able to go home when you feel ready. After a local or regional anaesthetic it may take several hours before the feeling comes back into your hand. Take special care not to bump or knock the area.

If you had a general anaesthetic, you will need to rest until the effects of the anaesthetic have passed. You will need to arrange for someone to drive you home. Try to have a friend or relative stay with you for the first 24 hours.

General anaesthesia temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 48 hours afterwards. If you're in any doubt about driving, contact your motor insurer so that you're aware of their recommendations, and always follow your surgeon's advice.

Your nurse will give you some advice about caring for your healing wound before you go home. You may be given a date for a follow-up appointment.

When You Return Home

Try to keep your hand above waist level during the first few days after the operation. This will help to reduce any pain and swelling. It's important to move your fingers and thumb regularly, so they don't become stiff.

You may need to take an anti-inflammatory drug, such as ibuprofen, for the first few days after the operation. This will to help relieve any pain and swelling in your hand.

Your stitches will be removed about a week or two after the operation. If you have dissolvable stitches, the amount of time they take to disappear depends on the type of stitches you have. They usually disappear in around two to three weeks, but it can sometimes take longer. You will need to keep your dressing and wound dry until the stitches have been removed.

Try to resume your usual activities as much as possible. You will usually be able to start moving your finger soon after surgery, when it is comfortable to do so.

You may need to have some hand therapy with a physiotherapist after the operation. This can help you to regain full use of your hand.

Some people feel tenderness, discomfort and swelling around the area of their scar for a while after the operation.

Trigger Finger Possible Risks

Trigger finger surgery is very safe, but there are possible complications. The most common problem is that the trigger finger can come back if the tendon sheath is not adequately released. Other possible problems include infection, stiffness of the finger, and damage to the nerves of the finger. The likelihood of these problems is very small, and trigger finger surgery has a very high success rate.