Trigger Finger

What is a trigger finger?
Your fingers are flexed by several tendons that run through pulley to keep them aligned. Certain people develop nodules in the tendons that trigger as they pull through the tight pulleys. This can cause sticking of the finger and pain.

How are trigger fingers treated?
Nonsurgical treatment: Injections of anti-inflammatory medications can be effective in the treatment of trigger finger. The space between the pulley and the tendon is instilled with a medication that reduces pain and swelling in the area. This can provide sufficient room for the tendon to glide without trigger and is often an effective treatment.

Surgical treatment: Patients who do not respond to injections can be treated with release of the affected pulley. There are five major components to the pulley system of the fingers and release of only the first portion is needed to treat triggering. That is why the procedure can be performed without causing future problems for the patient. Triggering fingers can be treated with open or percutaneous trigger finger release as described below.

Open trigger finger release: The surgeon makes a small incision at the base of the finger. The nerves that provide sensation to the finger are protected and the first portion of the pulley is divided with scissors. The finger is moved to verify the triggering is absent and the wound is closed. Surgery takes 10-15 minutes per finger and has a very high patient satisfaction rate. Complete recovery can take up to a few weeks but is usually faster than this.

Percutaneous trigger finger release: Trigger finger release can be performed in the office under local anesthesia using a percutaneous technique. Numbing medicine is injected in the hand near the base of the finger. A larger needle is then placed through the numb area and is used to divide the pulley that is causing the triggering. Advantages of this procedure include that it can be done in the office and does not require an incision. The main disadvantage is that the surgeon cannot see the pulley or nearby nerve and there is a possible higher risk of injury to the nerves or an incomplete release. While these complications are unlikely, patient should take them into account when choosing to have a procedure.

Which treatment should I select?
Each patient requires individual assessment of their symptoms prior to deciding the optimal treatment. Dr. Rose has experience with all the above techniques and can provide an assessment and explanation of the options available to you for trigger finger release. Please contact us to schedule an appointment.

Trigger finger references:
American Academy of Orthopaedic Surgeons Patient Information
American Society for Surgery of the Hand Patient Information