Trigger finger or stenosing tenosynovitis refers to the condition where the fingers lock or catch in a bent position and unfold with a snap. It often starts as a gentle snapping sensation and mild pain while flexing the fingers and becomes progressively worse with time.
There is a marked tenderness at the base of the affected finger which may appear to be stiff, with the pain being particularly worse in the mornings, more specifically, when you get up from sleep. With the passage of time, the pain becomes more acute and the affected fingers may appear to be stubbornly locked into the palm, considerably restricting the finger movement.
Trigger Finger Surgery – A Complete Update
Is Surgery the Only Treatment Option?
Trigger finger can be treated with alternative treatment options such as, hand therapy and cortisone injections around the area of inflammation. Apart from these, anti-inflammatory medication and the use of splints can also help in alleviating the symptoms of pain and inflammation.
However, these treatment options do not provide permanent relief and are useful only when the condition is treated in the early stages. Moreover, the chances of recurrence are quite high with the use of corticosteroid injections, though they have been found to be quite effective in relieving the symptoms.
Once the condition becomes worse and the fingers appear to be permanently locked in a bent condition, it is best treated with surgical release of the tight portion of the tendon sheath which is responsible for the catch in the fingers.
Procedure for Trigger Finger Surgery
Your surgeon may opt for an open surgery or percutaneous trigger finger release surgery depending on your condition. As the name suggests, open surgery is more invasive as compared to percutaneous release surgery. Both the procedures are performed under local anaesthesia and lead to some degree of numbness in the area.
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To perform an open surgery, the surgeon starts by making a small cut in the palm to reach the affected tendon. He then makes a cut into the tendon sheath to release the tendon which is responsible for the catch or snapping of the fingers. Once the tendon is released completely, the incision is closed with stitches.
Percutaneous trigger finger release surgery involves inserting a needle into the base of the affected finger. This needle is used to divide the ligament or the A1 pulley which is responsible for tendon restriction and movement of fingers. Once the procedure is performed, the needle can be removed from the base of the finger.
How Long Does Surgery Take?
Surgery for trigger finger normally does not take more than 15-25 minutes. However, the pre-operation and post-operation procedures take longer and usually last for 4-5 hours.
Recovery Time From Trigger Finger Surgery
Percutaneous trigger finger release surgery does not involve any incision or sutures and therefore requires very less healing time as there are no actual wounds to be healed. However, the numbness from local anaesthesia may last from 8-24 hours and it takes around 3-4 weeks to recover fully from the surgery.
Open surgery, however, involves stitches which are generally removed 8-10 days after the operation. Dissolvable stitches dissolve on their own in around 2-3 weeks. There might be some swelling and pain in the hands as the effects of the anaesthesia wear off, and the surgeon might prescribe some anti-inflammatory medication and painkillers for pain relief.
Though palm and hand movement is resumed within a day following the surgery, hand therapy is usually recommended if it takes longer than three weeks. Some degree of discomfort and numbness may also persist in the operated area for a few months or even up to a year, following the surgery.
Post-operative recovery time varies from person to person and generally depends on his/her health and overall well-being.
Do I Need to Worry About Complications from Surgery?
Surgery for trigger finger might be associated with certain risks, as is common with any surgical procedure. The most common risk factors include infection at the site of surgery, damage to the nerves or blood vessels, swelling, stiffness and tenderness in the operated area, restricted finger movement and a loss of grip.
Though some degree of stiffness, swelling and tenderness is common with surgery, presence of other complications, such as, fever, infection, nerve or vessel damage should be immediately brought to your doctor’s notice as they can result in severe health issues if left unchecked.
Swelling and stiffness which gets progressively worse with time and is accompanied with a red burning sensation and oozing of a foul smelling liquid from the wound normally indicates the presence of infection and should be treated immediately.
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