What Is Trigger Finger Release?
Each finger is bent by tendons that slide through a tunnel of tissue bands called pulleys. In trigger finger, also called stenosing tenosynovitis, the first pulley at the base of the finger (the A1 pulley) thickens or the tendon swells. The tendon catches as it passes through, causing clicking, painful snapping or a finger that locks in a bent position.
In a trigger finger release, the surgeon makes a small incision in the palm at the base of the affected finger and cuts the A1 pulley. This widens the tunnel so the tendon moves smoothly. Nearby pulleys stay intact, so the finger still bends normally.
Performed as an outpatient procedure at a surgery center where our surgeons operate, with evaluation and hand therapy here in our Boynton Beach office.
Who Is a Candidate?
Many people improve without surgery. Common first steps are resting the finger, a splint and a cortisone injection into the tendon sheath, which Dr. Tucker performs in our office. Surgery is usually considered if symptoms return after one or more injections, the finger locks and is hard to straighten, or if you have diabetes or another condition that makes injections less likely to work.
What to Expect
Trigger finger release is done at an outpatient surgery center, and you go home the same day. The procedure usually takes about 10 to 20 minutes and is commonly done under local anesthesia, sometimes with light sedation. You can often bend and straighten the finger right away, and you will be encouraged to move it gently to prevent stiffness.
If more than one finger is affected, or you also have carpal tunnel syndrome, these may sometimes be treated at the same visit. Dr. Tucker coordinates hand therapy when you need it, and our occupational and hand therapists, including Elise Burger, OTR, work in the same office and share your chart.
Risks and Side Effects
Trigger finger release is generally safe. Risks include infection, tenderness or a firm scar in the palm, stiffness, swelling, injury to a small nerve beside the tendon causing numbness, and, rarely, recurrence of triggering or a tendon that bowstrings. Let us know right away if you notice new numbness after surgery.
Recovery
Most people use the hand for light activities within a few days. Stitches usually come out in about 10 to 14 days. Soreness at the incision, some swelling and stiffness in the finger can last several weeks, and a finger that was locked for a long time may take longer to fully straighten. Hand therapy helps when stiffness persists. Return to heavy gripping and manual work typically takes a few weeks and varies.
Physical therapy happens in our office, with therapists who share your chart. Learn about on-site physical therapy.
Insurance and Cost
Trigger finger release is usually covered by Medicare and most commercial PPO plans when it is medically necessary. Some plans require prior authorization or documentation that injections were tried first. HMO and managed-care plans need your primary care physician's referral before the visit. Co-pays, co-insurance and deductibles apply. If the condition is related to your job, we accept workers' compensation and handle documentation. Call our office to verify your benefits.
When to Talk to a Specialist
Schedule a visit if a finger or thumb clicks, catches or locks, or if there is a tender lump at the base of the finger. See us sooner if a finger is stuck bent and you cannot straighten it. After surgery, go to the emergency room or call 911 for fever, spreading redness, drainage or rapidly worsening swelling.
