Trigger finger release

I have recently had a surgical procedure to release a bad trigger finger condition on the middle finger of my right hand which I previously discussed in my post titled ‘Trigger Finger and RSI?‘. The problem is also accurately summarised with diagrams on this page about trigger finger.

Trigger finger is where a finger in a gripping position appears to lock in place. When you pull the finger open, it unlocks with a click (or in my case a loud ‘clunk’ which made anyone around me squirm!), hence the name trigger finger. The condition is caused by a nodule growth on the tendon which gets stuck on the pulley (sheath) system that is there to guide/hold the tendon in place. Doctors have minimal knowledge about why this nodule forms. Nodules on tendons can come and go on their own, but this one has been bad and persistent.

The build up to the operation had certainly been playing on my mind for several months. Unsurprisingly the mental prospect of the surgery was the worst part since the operation itself was only 15min in duration and was carried out under local anaesthetic (although I avoided the temptation to watch it!).

The procedure itself involved cutting open the sheath(pulley) that was causing the tendon restriction to occur, which freed the movement of the tendon (and nodule). The surgical entry point was  on the palm of the hand just below the finger, and the incision itself was only about 1 inch long.

Recovery time has been fast. I am now nearly 3 weeks post op, the stitches are out , and the skin on the scar has fully healed over. I still have joint stiffness, and a bit of swelling which causes my finger to stiffen up in the bent position, but I expect this to gradually subside over time, especially after I keep stretching it like I have been instructed to do by the physiotherapists.

It is too early to do a complete assessment of the experience, but I can say that it’s great not having an annoying triggering finger condition any longer!

I wish there was a simple solution like this to my RSI condition!

UPDATE : 1 month post op

It’s now been about 1 month post operation, and I thought I’d update this post. Although the scar on the plam of the hand is healed over, however I still have a lot of  sensitivity about the entrance wound, as well as a lump under the wound. Not sure at this point if the lump is scar tissue or the nodule. The triggering has gone, but I still have a lot of stiffness in the joint, and the finger still likes to stick in the bent position (I have to physically bend it straight with my other hand). Hopefully this is just a result of the swelling and that this will go away on time. I am using the finger, but it can be sore depending on the task at hand.

Update: 2 1/2 months post op

The finger is getting  better all the time. It doesn’t stiffen up as frequently as before, but it still can stiffen quite badly and there is no cause I can determine for this. I recently had a follow up with the surgeon, and was advised that post op stiffness is common, and recovery can be as much as 18 months for some individuals – they don’t tell you that before the op! He suggested massaging the joint to reduce the swelling. The scar has totally healed up now, and is a whole lot less sensitive than it was a few weeks ago.

Update: 6 months post op

It’s certainly taken it’s time, but the finger is showing very little stiffness now. I can extend it fully contract it fully, grip things tightly, and have no sign of that horrible triggering any more. I can officially say the op was a success. It does go to show that there is a 3-6 month recovery term for this operation. Good luck with the operation if you are someone who is considering having it done and just factor in a few months for the recovery.

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4 comments

  1. Denise says:

    My middle finger right hand trigger release is 6 weeks post op now. I feel it is directly related to keyboarding and mousing. I’ve had a lot of swelling, stiffness and discomfort. I may be a bit impatient. The Occupational Therapist (US) has done massage and ultrasound several times. Back to the doctor next week to check in. It is quite painful when the swelling is at it’s max…. usually during mid morning to mid afternoon. I think it is slowly improving. I’m eager to get back to full activities, paddling occasionally and not worrying about whether to use my hand. It’s somewhat reassuring to read your article(s) as it seems our course is similar. typical?! 🙂

  2. alanf says:

    Hi Denise,

    thanks for your comment. I am now just over 3 months post op. The finger is good, but not great. Its got to the stage where I notice it less now, but it still can really stiffen up quite badly on occasion, usually after sleeping. It’s not too painful any more. I had a visit back to the surgeon, who told me that recovery from this op (re stiffness and swelling) can be anywhere from 6 to 18 months depending on person. (No mention of that before the op!) He also advised me to continually massage it and stretch it out myself which I’m kind of a bit negligent at doing because it is getting better gradually. At least the trigger condition is now gone. As you say I suspect it was computer use that caused it, but I have no proof.

    Alan

  3. Penney says:

    Thank you for this blog, my surgeon didn’t mention any post op stiffness or pain and it was reassuring to read your blog as I was beginning to worry.

  4. Karen says:

    I was diagnosed with trigger finger in my right index at the age of 5. I recall being told not to keep ‘clicking’ my finger or I wouldn’t be able to keep playing with my toys if it got stuck!

    Anyway, it eased off until I took my exams as a teenager. It’s generally hand writing that gives me the most trouble and that’s pretty intensive at that age. They tried the release op twice, but in each case the sheath seemed to heal up just as tight as it had been before. Probably something to do with scar tissue they thought.

    As it failed twice they decided there was no point trying again. I was told to take ibuprofen prior to any intensive use of my hand, which I’ve done for all exams since. Many years later I found out that I might have reduced the scarring and improved things if I’d been massaging the scar.

    I am lucky though as it isn’t a problem for me day to day. I can’t go bowling as that really hurts, if I’m doing a lot of writing I know it’ll hurt and it locks up if I do too much stuff that involves gripping (sawing, hammering etc).

    I mention this as I am certain it’s got nothing to do with using a computer. It occurred long before I’d even seen on, and although I use them a great deal now, typing has never caused it to flare up.

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