Complications of open trigger finger release

Open release of A1 pulleys for trigger finger has been thought of as a relatively benign procedure with a low complication rate. Few studies have examined the rate of complications in trigger finger release. The objective of this study was to retrospectively review the complications documented for a cohort of patients who received open trigger finger releases.

We conducted a retrospective chart review of 43 patients who had had 78 open trigger finger releases by a single surgeon. Any postoperative complications that were documented were recorded. Complications were then divided into major and minor. Major complications required further surgery or resulted in significant limitations of activities of daily living; minor complications hindered recovery, responded to treatment (if applicable), and either resolved or had little impact on function.

Two major complications were noted: a synovial fistula that required excision, and proximal interphalangeal joint arthrofibrosis that required cast application for pain relief. The major complication rate was 3% per trigger release (2/78). Twenty-seven minor complications in 22 digits were documented for these cases, including decreased range of motion, scar tenderness, pain, and wound erythema. The minor complication rate was 28% (22/78). The overall, combined complication rate for these primary interventions was 31% (24/78).

Open trigger finger release is thought to be a low-risk procedure by most practitioners. In this study, we found that major complications do occur infrequently; however, the rate of minor complications was surprisingly high and related mostly to wound complications or loss of finger range of motion. The surgeon performing open trigger finger releases should inform the patient of the likelihood of having these minor complications.