Trigger Finger
Trigger finger (stenosing tenosynovitis) occurs when a finger or thumb catches or locks when bent, then releases with a snap, like pulling and releasing a trigger. It results from inflammation or thickening of the flexor tendon or its sheath at the A1 pulley at the base of the finger, creating a size mismatch that prevents smooth tendon gliding. Trigger finger most commonly affects the ring finger and thumb. Treatment ranges from splinting and corticosteroid injection to surgical release of the constricting pulley.
What does a Trigger Finger release procedure involve?
Your surgeon will assess the degree of triggering or locking, palpate for a tender nodule at the base of the finger, and evaluate range of motion. Conservative treatment — activity modification, splinting, and corticosteroid injection — is typically tried first. Injection provides relief in sixty to seventy per cent of cases.
If conservative treatment fails, surgical release takes fifteen to twenty minutes per finger under local anaesthetic as day surgery. A small incision (one to two centimetres) in the palm exposes the A1 pulley, which is divided completely to allow smooth tendon gliding. A percutaneous technique using a needle is also available for fingers (not the thumb), though with slightly less visualisation. Multiple fingers can be released in one session.
Immediate finger movement is encouraged after surgery.
Your Recovery
Triggering resolves immediately after surgery. Soreness at the incision and palm tenderness are common for four to eight weeks. Sutures are removed at ten to fourteen days. Light activities are possible immediately; heavy gripping should be avoided for two weeks. Desk work is possible within a few days; manual labour within two to four weeks. Success rate exceeds ninety-five per cent.
Risks and Complications
Nerve injury causing numbness along the finger (digital nerve runs close to the A1 pulley)
Incomplete release with persistent triggering
Scar tenderness
Bowstringing if too much pulley is released (rare)
Stiffness requiring therapy
Infection (rare)
Frequently Asked Questions
Should I try a cortisone injection before surgery?
Yes. Most surgeons recommend at least one injection before surgery. If it fails or symptoms recur, surgical release is very effective and provides permanent relief in the vast majority of cases.
Will the triggering come back after surgery?
Recurrence after complete release is very rare — less than three per cent.
THE SPECIALIST CLINIC DUBLIN
Plastic, Reconstructive & Aesthetic Surgery performed with Care & Compassion
To discuss trigger finger treatment, contact us to arrange a consultation.