Trigger finger surgery is a very safe procedure for releasing tight tendon sheaths to allow people to freely move their fingers if they do not respond to more conservative treatments. Patients can usually start using the affected hand on the day of surgery, although it will take several weeks to build up strength. One of the biggest risks is the chance of recurrence, where the tendon swells again and the sheath tightens, causing movement restriction.
In trigger finger, patients experience a popping or snapping sensation as they bend or straighten fingers. This happens because the tendon sheath has become too narrow in one portion, and the tendon has trouble pulling smoothly through the sheath as the finger moves. In some cases, the finger becomes stuck in position because it is not possible to move the tendon back. This is most commonly an occupational illness, caused by repetitive motion and strain.
Surgery for trigger finger involves a local or regional anesthetic to numb the hand. The patient may receive a sedative to stay calm, but will be awake and aware. A hand surgeon will make a careful incision to access the area, and cut the swollen sheath open to free the tendon. The surgeon may ask the patient to flex the finger to make sure the problem is gone, and then closes the incision. Over time, the severed sheath heals over, with more room for the tendon.
After trigger finger surgery, patients may feel numb for several hours. The anesthetic wears off slowly, providing postoperative analgesia. Typically the surgeon applies a small bandage. The patient will need to keep the hand clean and dry for several days, and stitches will be taken out after 10 days. At this follow up appointment, the surgeon will check to see if the patient's hand is healing well.
Some patients may need physical therapy after trigger finger surgery to recover range of motion. Surgeons may also recommend wearing pressure garments on the hand to limit scar formation. Scars can be unpleasant to look at and will also limit the patient's movement, making it important to prevent them, if possible. Surgeons also use minimally invasive techniques to keep incisions small.
Patients may notice some tenderness and swelling for several days. This should resolve. If the hand feels hot or unusually tender, this is a cause for concern. Foul-smelling discharge after trigger finger surgery is a sign of infection. Patients should also be aware of a small risk of nerve damage in surgery, as the hand nerves run close to the tendons. Numbness, tingling, and loss of sensation after trigger finger surgery should be reported to the surgeon.