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Trigger finger is a problem that can develop over time. There is usually no one specific cause of this disorder; however, it does occur more frequently in diabetics. This pathology may cause a bothersome clicking or locking of your finger that can be painful at times, and patients may not be able to straighten the finger without using assistance from the other hand. You may even feel a small painful nodule at the base of your finger. The snapping or clicking that’s felt is a result of inflammation surrounding the flexor tendon in your finger, whereas a normal tendon glides smoothly through several pulleys. When inflammation develops, the tendon may get stuck on the wrong side of the pulley and prevent you from straightening the finger.

Treatment for this condition usually begins with a corticosteroid injection. This injection has anti-inflammatory properties which should allow the inflammation surrounding the tendon to subside. If a corticosteroid is not successful after two attempts and the issue is persisting, then you may be a candidate for surgery.

If a corticosteroid injection does not successfully treat your trigger finger after two attempts, then you may be a candidate for either percutaneous trigger finger release or open trigger finger release.

Percutaneous trigger finger releases can be done in the office. The finger of interest must be reproducibly triggering so that we are able to determine whether or not the pulley is successfully released. Local anesthesia is given, and a small poke hole is made in the skin. A needle is used to cut and release the pulley that the tendon is getting caught on. The finger is then tested to ensure that it is no longer getting caught. A compressive dressing is placed for the patient to wear over the next few hours. The area may be sore for a few weeks while everything heals. Hand and finger range of motion is encouraged immediately after the procedure. This is only an option for certain patients depending on the finger involved and the severity of the triggering.

The open trigger finger release may also be done under straight local anesthesia, but this procedure is done at a hospital or ambulatory surgery center. It involves making a small incision at the base of your finger over the involved pulley. The pulley is cut so that your tendon will glide smoothly without getting caught. A soft dressing is placed after surgery that may be removed after two to three days. Stitches will be removed in the office two weeks after surgery. Hand and finger range of motion is encouraged immediately after surgery, and full recovery usually takes a few weeks.