I have opted to have a surgical repair for my trigger finger. I tried a cortisone injection that failed. What are my risks?

There are two options for surgical repair of a trigger finger, open release and percutaneous release, both of which present with their own possible adverse effects.

The research investigating effectiveness and complications associated with open A1 pulley release surgery treating trigger finger indicates success rates varying from a 60 per cent to 100 per cent rate of symptom resolution. Adverse effects with open trigger finger release may include infection, nerve injury, slow range of motion recovery or bowstringing. Research has looked at the rate of adverse effects with findings ranging from less than one per cent to five per cent. One study identified adverse effects occurring in 30 per cent of patients, but this particular study included swelling and pain as adverse effects.

Research investigating percutaneous A1 pulley release is meager compared to the research investigating open A1 pulley release for trigger finger. Excluding the research of percutaneous release on thumbs, which is a procedure much more difficult to perform, and excluding cadaver studies, the success rates vary from 91 per cent 100 per cent. Complications of percutaneous release may include risk of incomplete release, superficial tendon abrasions, and neurovascular damage. Risk of these complications ranged from zero percent to 60 percent, with the 60 per cent being primarily superficial tendon abrasions.

Comparing outcomes of open versus percutaneous A1 pulley release surgery shows that those undergoing percutaneous repair reported post-operative pain lasting only 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.