Trigger finger release, or A1 pulley release, is a surgical procedure to treat a condition called trigger finger or stenosing tenosynovitis. A trigger finger is a condition where one of the fingers or the thumb becomes stuck in a bent position and suddenly pops back into place, resembling pulling a trigger. The condition occurs when the tendons in the finger become inflamed or thickened, making it difficult for them to move smoothly through the sheath surrounding them. The affected tendon gets stuck under one of the pulleys that keep it in place, usually the A1 pulley.
Trigger finger release is typically recommended for individuals diagnosed with trigger finger (stenosing tenosynovitis) who experience symptoms that significantly affect their daily activities and quality of life. If conservative treatments such as rest, splinting, medication, and hand therapy have not provided sufficient relief or if the condition has progressed to the point where the finger becomes locked in a bent position, trigger finger release may be considered.
Consult an orthopaedic surgeon to determine if trigger finger release is appropriate for your condition.
There are two main types of trigger finger release procedures: open trigger finger release and percutaneous trigger finger release.
Open trigger finger release, also known as open-release surgery, is the traditional and most commonly performed method for trigger finger release. It involves making an incision in the palm near the base of the affected finger to access the affected tendon sheath. The surgeon carefully cuts and releases the pulley over the constricted portion of the sheath to allow the tendon to move freely. This technique visualises the affected area, allowing for precise surgical manipulation. After the procedure, the incision is closed with sutures, and a bandage is applied to protect the finger during the initial healing phase.
Percutaneous trigger finger release, also referred to as needle release or percutaneous release surgery, is a minimally invasive alternative to open trigger finger release. In this technique, the surgeon uses a needle to penetrate the skin near the base of the affected finger. The needle is then used to divide the constricted portion of the tendon sheath, allowing the tendon to move freely. This method avoids a traditional incision and typically requires only a local anaesthetic. Percutaneous trigger finger release may result in a smaller scar and faster recovery than open-release surgery.
Both open and percutaneous trigger finger release procedures effectively alleviate symptoms and restore finger function. The decision regarding which technique to pursue should be made in consultation with your surgeon based on their assessment of your condition.
Before considering trigger finger release surgery, conservative treatment options are often explored. These alternatives may be recommended initially or attempted if the symptoms are not severe or significantly impacting daily activities. Some alternative options include:
These alternative options may not provide long-term relief for more severe cases of trigger fingers. Trigger finger release surgery may be recommended if conservative treatments fail to alleviate symptoms or the condition worsens.
Before undergoing trigger finger release surgery, it is important to follow these steps:
By following these steps and maintaining open communication with your surgeon, you can prepare adequately for trigger finger release surgery and increase the chances of a successful outcome.
Several key steps are involved during a trigger finger release procedure, whether it is an open or percutaneous technique. Here's an overview of what typically happens during a trigger finger release:
Following the procedure, you will be monitored in a recovery area. Once you are stable and alert and no complications are observed, you will be discharged to go home the same day.
A comprehensive recovery plan is crucial after a trigger finger release surgery to promote healing, minimise complications, and restore optimal hand function. While every individual's recovery may vary, here is a general outline of a trigger finger release recovery plan:
The prognosis for trigger finger release surgery is generally positive. The procedure is usually effective in alleviating symptoms and restoring normal finger function.
In most cases, trigger finger release surgery relieves symptoms such as finger stiffness, locking, and pain. Recovery time can vary, but many individuals experience improvement within a few days to a few weeks. Full recovery and optimal finger function may take several weeks to several months.
While trigger finger release surgery is generally safe and well-tolerated, as with any surgical procedure, there are potential risks and complications. Potential complications may include infection, bleeding, nerve injury, or recurrence of trigger finger symptoms. Following your surgeon's postoperative instructions, attend follow-up appointments and promptly report any concerns or complications.
Consult with your orthopaedic surgeon to discuss your condition, prognosis, and potential trigger finger release surgery risks. They will provide personalised guidance based on your unique circumstances and help manage your expectations regarding the recovery process.
Trigger finger symptoms can worsen if left untreated, especially if the condition is caused by underlying inflammation or structural changes in the tendon sheath. Delaying surgery may result in increased pain, finger stiffness, and difficulty performing daily activities.
Consult an orthopaedic surgeon to determine the most appropriate timing for trigger finger release based on the severity of your symptoms, overall hand function, and potential risk factors.
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