I have been diagnosed with a trigger finger. What are my treatment choices?

The most conservative treatment is a simple cortisone injection into the affected tendon. This anti-inflammatory can sometime provide enough to allow the tendon to release and remodel. If the cortisone injection does not work, surgical options are your next choice. There are two surgical options, an open A1 pulley release or a percutaneous A1 trigger release. An open trigger release is considered the gold standard as it has a high success rate with little complications. It involves creating an incision to openly release the affected tendon. Percutaneous trigger release is another option that is becoming increasingly more popular in recent years with proponents claiming that it is a much simpler procedure that often results in a less painful and faster recovery. It involves using a hypodermic needle or specially desigen scalpel to release the affected tendon without an open incision. Percutaneous release can be done in a office setting, thus minimizing cost.

There is strong research with large sample sizes investigating open repairs, whereas the research is relatively meager investigating percutaneous repairs. Looking at the studies that have compared the two methods, those undergoing percutaneous repair reported post-operative pain lasting only about three days compared to almost six days for open repair. Return to work was four days for the percutaneous repair compared to seven and a half days for the open repair. According to these comparative studies, there was no difference between the two groups with regards to failure or complication rate.

Overall, percutaneous repair for trigger finger is promising in being both highly effective and economical, though strong research is currently lacking. As new techniques, such as ultrasound guided releases, and new equipment, such as specially designed scalpels, are introduced, randomized trials comparing these methods are warranted. If you are uninsured or worried about cost, a percutaneous repair may be in your best interest. It is best to discuss with your surgeon which method he or she is most accustomed to performing.