TRIGGER FINGER RELEASE
For Patients in Pain from a condition called Trigger Finger
Trigger finger is a common condition in patients who do repetitive gripping or flexing of their fingers and hand. The tendons that flex the fingers run under a ligament, the A1 pulley, which keeps the tendons in place. In some cases, the tendons can get swollen from inflammation and develop a nodule that starts catching and popping under the ligament. In severe cases, the tendon can get so swollen that it will get stuck and will no longer bend the finger.
Frequently, the patient is offered a course of hand therapy to try to restore the full range of motion of the finger. In addition, anti-inflammatory medications, steroid injection, and a finger splint may be offered to treat the pain and inflammation.
For many years, the definitive treatment was surgery through an open incision, releasing the A1 pulley, and allowing it to heal in a stretched position. This would take the pressure off the finger, allowing the finger to bend again without getting stuck. However, an open release requires wound care, removing stitches a week after the procedure, risk of infection, and prolonged return to work due to the wound healing, and up to 4 weeks of restricted hand function. There is also potential for complications from the surgical healing, including pain and extensive scarring.
Currently, there is a minimally invasive technique to perform a similar release without a surgical incision. It is called a Percutaneous Trigger Finger Release Under Ultrasound Guidance. This procedure consists of injecting lidocaine locally to numb the area and releasing the A1 pulley with a needle under live ultrasound imaging. There is no incision with a scalpel so the recovery is much quicker, and with a much lower risk of infection. The patient can immediately bend the finger after the procedure, and the needle puncture can be managed with a band aid for 24 hours, without the need for stitches. In 3 days, the patient can resume light gripping, and can return to full gripping as soon as ten days. Pain and scar tissue formation are minimal given the lack of an incision. In addition, this procedure is cheaper than open surgery since it is performed in the office and does not require surgical fees.
Trigger Finger Release research:
https://pubmed.ncbi.nlm.nih.gov/36478278/