Having a Trigger Finger Release

Is an operation always necessary?

Having a trigger release is your choice – it is very safe to live with a trigger finger, which very rarely causes harm, and which often resolves on its own with no treatment. So the alternatives to surgery are:

• Doing nothing! There is no guarantee that a trigger finger will resolve in time, and sometimes a trigger finger becomes fixed in flexion, with increased impact on function. Overall, however, it is very safe to do nothing with this condition.
• Wearing splints. Wearing a trigger finger splint overnight for a few months may help resolve the triggering symptoms.
• Steroid injection. Steroid injections usually result in around 90% of patients requiring no further treatment.

What happens on the day of surgery?

What should you do to prepare?

Read about Having an operation on your hand or arm. This runs through most of the risks involved with the surgery, and it is really important that you are aware of this risk before agreeing to the surgery.

Planning for when you get home is also important. Although there are no restrictions on how you use your hand after the surgery, your hand will not work the way you want it to in the first few weeks after the operation. You can help make things easier by:

• Making sure you have a good weeks supply of food and provisions in the house
• Having some ready meals or easy prep meals available
• Planning to wear loose fitting clothing such as joggers and t-shirts for the first few days

What type of anaesthetic is used?

Trigger finger release is done under local anaesthetic, using a technique called WALANT surgery. The local anaesthetic usually lasts a few hours, then slowly wears off.

• The anaesthetic is put in using a very fine needle in the anaesthetic room.
• The anaesthetic is designed only to numb the area of the operation and not the whole hand.

What exactly does the surgeon do?

The surgeon’s job is to divide the thickened tissue (the pulley) above the area causing the triggering. The anaesthetic contains adrenalin, which stops blood flowing into the numb area for a while – this makes the area of the had which is numb appear white.
An incision is made in the skin crease, and the underlying pull cut to allow the tendon to run smoothly.

At the end of the operation, the surgeon will usually check the movement of the hand. You will also be able to assess the hand yourself once the trigger finger has been released. A small dressing will be applied to the wound as well as a bulky bandage.

After the operation

Is it safe to use the hand after the operation?

It is quite safe to use the hand as normally as possible after the operation. We recommend that you keep the hand moving – touch your thumb to each fingertip in turn, fully straighten your fingers and then make a full fist around 10 times every half hour until your hand is working normally – this is for movement only, and you do not need to put any power into the fist!

What will the scar be like?

The scar is usually around 2-3cm long and quite tender to begin with. People often think that once the skin has healed the hand should feel normal, but the operation involves deep structures in the hand, and can take many weeks to fully settle. As a rough guide:

• 2 weeks – Wound has healed. You should keep the wound clean and very dry until this point. It is usually safe to shower with the wound at 2 weeks, but wait until around 4 weeks before soaking it in a bath.
• 6 weeks – The scar is red and still tender. The area around the scar feels firm and tender. It is still uncomfortable to put pressure on the hand, and grip still feels weaker than normal.
• 3 months – Usually by 3 months, the hand function is back to normal.
• 6 months – By 6 months, the scar should now be a thin white line, and hopefully you should have forgotten about the operation!

What happens after the operation?

You will be discharged home within an hour or so of the operation. The hospital rules state that you have to be accompanied home, so you will need to ask a friend or relative to come and pick you up.

You should make an appointment with your practice nurse at your GP practice to get your wound checked in 7-10 days. There may be sutures to remove but you will be advised of that following your procedure. We usually put you in charge from here on in – if you need to see us, you can contact us as you feel necessary.

When is it safe to drive after the surgery?

Remember that it is your responsibility to ensure that you are safe to drive by law! Most people return to driving at around 2-3 weeks after their operation. There is further guidance on this on our ‘Having an operation‘ page.

When is it safe to work after the surgery?

There are no restrictions on how you use your hand after the operation, so if you have a desk job you can potentially go back to work straight away. Most people with light manual jobs go back at around 2 weeks, and heavy manual workers might need longer than this.