Orthopedics

OSPI offers the top orthopedic surgeons in Gilbert AZ and the East Valley. Drs. Mahoney, Macqueen, Stewart and Clouse offer minimally invasive General, Sports and Joint Replacement expertise.

Physical Therapy

Whether you are pre or post-operative, OSPI’s East Valley physical therapy team works with you on both active and passive treatments. Your will be in the best hands with our licensed physical therapists!

Chiropractic

The Gilbert chiropractors at OSPI offer a plethora of nonoperative pain relief options such as manipulations, laser therapy, physiotherapy and electrical stimulation.

Family Practice

OSPI offers comprehensive family practice services including allergy testing, BHRT, medical weight loss, aesthetics and full check ups.

Medical Weight Loss

Patients routinely experience dramatic, healthy weight loss with the customized programs at OSPI. The programs combine nutrition, exercise and prescription weight loss options.

Performance Training

OSPI’s integrated team of healthcare providers work with both amateur and professional athletes to maximize one’s performance with sport specific programs.

Pain Management

OSPI’s Board Certified, Fellowship Trained pain doctor offers both medication management and interventional procedures with exceptional outcomes!

Trigger Finger Surgery

FAQs on Trigger Finger Surgery in Gilbert, Chandler, Mesa AZ

 

About 50 percent of trigger finger incidents are treated with surgery. Performed as the last option after all nonsurgical methods fail to provide relieve, trigger finger surgery heals within a few weeks providing permanent relief from the disorder and consequent disability.

What is a trigger finger?

Trigger finger refers to a condition where your finger is stuck in a trigger-pulling position due to sticking of the flexor tendon. It becomes difficult to straighten the finger and the finger unlocking resembles as if you pulled a trigger and release your finger.

Known as stenosing tenosynovitis in medical annals, the condition is attributed to thickening of the sheath covering the finger base. Flexor tendons pass through tunnels at the base of fingers and slide in these tunnels as we pull or push fingers. But the thickening of the sheath squeezes these tunnels leaving less space for flexor tendons to slide. Similarly, formation of nodules on tendons due to inflammation restricts space in the tunnels. As a result, tendons get stuck causing trigger finger.

Those with diabetes, rheumatoid arthritis, and gout are at increased risk of trigger finger disorder. About 3 in every 100 are likely to have the problem that results in stiffness, pain, swelling, popping sensation, and disability in the affected finger.

What is trigger finger surgery?

Trigger finger surgery is a surgical procedure to treat the frequent sticking of one or more finger. An incision is made in the palm to cut open the A1 pulley. The A2 pulley is strong enough to take the burden and the procedure does not impact any physical or functional trait of the area. The release of the A1 pulley ensures smooth gliding of the flexor tendon without getting stuck.

There are two types of techniques used to perform trigger finger surgery.

  • Open surgery or an incision on the palm to reach tendon pulley and cut the ligament.
  • Percutaneous trigger finger release, where a needle is used back and forth multiple times to cut the pulley and free the flexor tendon

Who is a candidate for trigger finger surgery?

A patient is considered for trigger finger surgery if

  • there is no relief despite using nonsurgical treatment for long
  • severe symptoms, including pain and swelling, cause disability over an extended period
  • patient is unable to stretch affected fingers
  • fingers remain fixed too often
  • help of the other hand is needed to unlock the locked finger

How is trigger finger surgery performed?

Trigger finger surgery is performed in an outpatient setting. The procedure depends on the type of surgery.

  • Open Surgery

An incision is made to access tissues at the flexor tendon sheath. The sheath is cut to reach the flexor tendons. The finger is flexed to assess the cause of sticking and how it catches at the A1 pulley. The pulley is cut and released after nearby tissues are pulled away.

As the pulley is released, flexor tendons are pulled back and forth to confirm that they are gliding smoothly without facing any obstacle. Once confirmed, the incision is closed and bandage is applied.

The entire procedure is performed under local anesthesia.

  • Percutaneous Trigger Finger Surgery

This surgical procedure is minimally invasive and performed though the skin without an open incision. Surgeons use a needle as a scalpel. The needle is inserted at the A1 pulley position. It is moved back and forth to cut the ligament. Once the surgery is done, it is taken out and the area is bandaged.

The percutaneous trigger finger surgery is usually done under local anesthesia. It does create any incision and there is no need for healing. However, the procedure has its limitations. Its use is restricted to less serious conditions, as it may not be able to cut the more stiffened sheath and successfully release the pulley. The procedure may also cause damage to tendons or nerves.

How long does trigger finger surgery take?

The procedure takes about 15 to 30 minutes.

Do I need to stay at the hospital after trigger finger surgery?

The surgery is an outpatient procedure and patients are discharged within an hour.

Do I need rest after trigger finger surgery?

Patients require rest for one or two days after surgery to avoid any infection. Pain, swelling, and soreness return after the anesthesia wears off. Medication and therapy helps overcome these temporary surgical effects.

What are the restrictions following trigger finger surgery?

  • Keep the bandage clean and dry
  • No driving for a week
  • Avoid grasping or pinching for 2 weeks
  • Keep your hand in a elevated position for 3 to 5 days to reduce swelling
  • Limit activities with the hand for 6 weeks
  • No heavy lifting or repeated finger movements for 2 weeks

What kind of rehabilitation is needed following trigger finger surgery?  

Trigger finger surgery does not require lengthy rehabilitation. You can start finger movements from day one to overcome stiffness and also do soft massaging. Limit the finger and hand exercises to your tolerance level and avoid repeated finger movements for 2 weeks. Press softball and open and close your hand several times a day for 3 weeks.

How long is the recovery period following trigger finger surgery?

The finger and palm recovers significantly in a week and gets better gradually. However, patients have to wait for 2 to 3 months to regain full finger strength. They can return to sedentary jobs after 3-4 days. But it is advised to have a 6-week break for jobs requiring repeated finger use, high-strength grasping, or hand vibration.

Patients can start using keyboards or drive without pain after a week and play racquet sports in 3 weeks. They can join manual labor after 3-4 weeks. All stiffness goes in 6 months assuring complete recovery.

What are the potential complications of trigger finger surgery?

Trigger finger surgery may lead to temporary swelling, pain, stiffness, and other surgical complications. Lack of adequate care during the first few days may lead to infection at the place of incision. The skin is scarred and its contour may change. Surgical mistakes may damage tendons and nerves and even fail to provide significant relief.

References

Bamroongshawgasame T. A comparison of open and percutaneous pulley release in trigger digits. J Med Assoc Thai. 2010 Feb. 93(2):199-204.

Will R, Lubahn J. Complications of open trigger finger release. J Hand Surg Am. 2010 Apr. 35(4):594-6.

Schramm JM, Nguyen M, Wongworawat MD. The safety of percutaneous trigger finger release. Hand (N Y). 2008 Mar. 3(1):44-6.

Miyamoto H, Miura T, Isayama H, Masuzaki R, Koike K, Ohe T. Stiffness of the first annular pulley in normal and trigger fingers. J Hand Surg Am. 2011 Sep. 36(9):1486-91.

Stenosing tenovaginitis of the wrist and fingers. Clin Orthop Relat Res. 1972 Mar-Apr. 83:87-90.

Sato ES, Gomes Dos Santos JB, Belloti JC, Albertoni WM, Faloppa F. Treatment of trigger finger: randomized clinical trial comparing the methods of corticosteroid injection, percutaneous release and open surgery. Rheumatology (Oxford). 2012 Jan. 51(1):93-9.

Ryzewicz M, Wolf JM. Trigger digits: principles, management, and complications. J Hand Surg Am. 2006 Jan. 31(1):135-46.

Lange-Riess D, Schuh R, Hönle W, Schuh A. Long-term results of surgical release of trigger finger and trigger thumb in adults. Arch Orthop Trauma Surg. 2009 Dec. 129(12):1617-9.

Wolfe SW. Tenosynovitis. Green DP, ed. Green’s Operative Hand Surgery. 4th ed. New York, NY: Churchill Livingstone; 1998. vol 2

 

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