Abhinav Gulihar is a highly experienced orthopaedic surgeon providing specialist care for patients in London and Kent. As a consultant with a dedicated interest in hand and wrist surgery, he treats a wide range of conditions, including trigger finger, tendon disorders, and complex wrist injuries such as distal radius fractures.
Trigger finger or trigger thumb is a common condition that causes painful clicking, catching, or locking of a finger or thumb during movement. In more advanced cases, the finger may become stuck in a bent position and require manual straightening. When non-surgical treatments are no longer effective, Trigger Finger / Thumb Surgery can provide a definitive and long-lasting solution.
Mr Gulihar offers expert assessment and modern surgical treatment, helping patients regain smooth, pain-free movement and return to everyday activities.
Understanding Trigger Finger and the Need for Surgery
Trigger finger (stenosing tenosynovitis) occurs when the A1 pulley, a fibrous band at the base of the finger or thumb, becomes thickened and inflamed. This narrowing restricts the smooth movement of the flexor tendon, causing it to catch or lock as the finger bends and straightens.
Early treatment often includes rest, splinting, anti-inflammatory measures, or steroid injections. Surgery is recommended when:
- Symptoms persist or recur despite injections
- Locking becomes frequent or painful
- The finger or thumb locks in a bent position
- Hand function or work activities are significantly affected
Surgical release provides a permanent solution by dividing the thickened pulley and restoring unrestricted tendon movement.
Surgical Options for Trigger Finger / Thumb
finger involved, anatomy, and individual circumstances.
Open Trigger Finger Release
Open release is the traditional and most commonly performed procedure. A small incision is made in the palm, allowing direct visualisation of the A1 pulley, which is then carefully released.
This technique has an excellent success rate—reported to be up to 99%—and provides predictable, long-term relief. It is suitable for all fingers and thumbs and is often preferred in complex or recurrent cases.
Ultrasound-Guided Trigger Finger Release (Minimally Invasive)
Ultrasound-guided trigger finger release is a minimally invasive technique performed using real-time ultrasound imaging. Ultrasound allows precise visualisation of the tendon, pulley, digital nerves, and blood vessels during the procedure.
A very small skin entry point is used, and specialised instruments release the A1 pulley under continuous ultrasound guidance. This approach aims to minimise soft-tissue disruption and may allow for quicker early recovery, reduced wound discomfort, and no formal surgical incision.
Suitability depends on finger anatomy, severity of triggering, and clinical findings. Mr Gulihar will advise whether this technique is appropriate for you.
Comparison of Surgical Techniques
| Surgical Technique | Skin Opening | Success Rate | Key Advantage |
| Open Release | Small palm incision | Up to 99% | Gold-standard, highest reliability |
| Ultrasound-Guided Release | Very small entry point | High (patient-dependent) | Minimally invasive, quicker early comfort |
What to Expect from Your Surgery
Trigger finger surgery is a short and highly effective procedure, usually taking less than 10 minutes and performed under local anaesthetic as a day case.
Most patients experience immediate relief from locking and catching. While the mechanical problem is resolved straight away, mild swelling, tenderness, or stiffness may persist temporarily as tissues heal.
Mr Gulihar will provide clear post-operative advice and follow-up to ensure a smooth recovery.
Recovery After Trigger Finger / Thumb Surgery
Recovery is usually rapid, and early movement is encouraged.
Immediately After Surgery
- You will be asked to move the finger straight away
- Mild palm soreness is normal
- Elevation helps reduce swelling
First Few Weeks
- Wound healing occurs within 1–3 weeks
- Light daily activities are resumed quickly
- Average return to normal activities:
- Ultrasound-guided release: often within a few days
- Open release: around 2–3 weeks
- Ultrasound-guided release: often within a few days
Up to 4–6 Months
- Residual swelling or stiffness gradually resolves
- Hand therapy may be advised if stiffness persists
Potential Complications and Risks (Detailed)
Trigger finger surgery is very safe, but no surgical procedure is completely risk-free. Complications are uncommon and usually minor, but may include:
Common and Usually Temporary
- Stiffness – the most frequent issue; improves with early movement and, if needed, hand therapy
- Swelling and Tenderness – particularly in the palm, settling over weeks
- Scar Sensitivity – more common after open release; usually improves with massage and time
Less Common Risks
- Infection – rare and typically superficial; usually treated successfully with antibiotics
- Bleeding or Bruising – small collections of blood may cause temporary discomfort
- Incomplete Release – persistent triggering may require further treatment
Nerve and Tendon-Related Risks
- Digital Nerve Irritation or Injury – may cause temporary or, very rarely, permanent numbness or tingling
- Tendon Injury – extremely rare, particularly with ultrasound guidance
Rare but Important Complications
- Complex Regional Pain Syndrome (CRPS) – a rare condition causing prolonged pain, swelling, and stiffness
- Recurrence – uncommon (generally <3%), but possible, particularly in patients with diabetes or inflammatory conditions
Mr Gulihar will discuss your individual risk profile and explain how these risks are minimised.
Frequently Asked Questions About Trigger Finger / Thumb Surgery
1. Is trigger finger surgery painful?
No. It is performed under local anaesthetic, so you should not feel pain during the procedure. Mild soreness afterwards is normal and usually short-lived.
2. How soon can I use my hand after surgery?
You can start moving the finger immediately. Most patients return to light activities within a few days.
3. When can I return to work?
Desk-based work is often possible within days. Manual work may take 2–4 weeks, depending on comfort and strength.
4. Will I need physiotherapy or hand therapy?
Most patients do not, but therapy may be recommended if stiffness or swelling persists.
5. Will I have a scar?
Open release leaves a very small scar in a natural palm crease. Ultrasound-guided release does not involve a formal incision.
6. Is ultrasound-guided release as effective as open surgery?
In appropriately selected patients, outcomes are excellent. Open release remains the gold standard, particularly for complex cases.
7. Can more than one finger be treated at the same time?
Yes, in selected cases multiple digits can be treated during the same procedure.
8. Can trigger finger come back after surgery?
Recurrence is rare and occurs in fewer than 3% of cases.
9. Are diabetics more likely to need surgery?
Yes. Trigger finger is more common in diabetes, and injections may be less effective, making surgery more likely.
10. What warning signs should I look out for after surgery?
Increasing redness, swelling, discharge, fever, worsening pain, or persistent locking should be reported promptly.
11. How do I know if surgery is the right option for me?
A consultation with Mr Gulihar will confirm the diagnosis and determine the most appropriate treatment.
Book Your Appointment with Mr Abhinav Gulihar
If trigger finger or thumb symptoms are affecting your comfort, work, or quality of life, specialist assessment can provide clarity and effective treatment. To book a consultation with Mr Abhinav Gulihar in London or Kent, please get in touch with the clinic.