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Liberación de dedo en gatillo

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Post-operative exercises and precautions after trigger finger release, including tendon glides and joint blocking exercises.

Updated Jun 2026
Ilustración de los tendones flexores de la mano, donde una pequeña hinchazón queda atrapada bajo una polea en la base del dedo.
Dedo en gatillo: la hinchazón del tendón flexor queda atrapada bajo la polea situada en la base del dedo. Kieran Hirpara 4.0

Esta página se tradujo automáticamente y todavía no la ha revisado un médico. La versión en inglés es la versión oficial.

Este protocolo le servirá de guía durante su recuperación tras la liberación de dedo en gatillo realizada por el Dr. Kieran Hirpara en el Mater Private Hospital Rockhampton. Explica qué esperar, las precauciones que debe tomar y el programa de ejercicios postoperatorios. Por favor, lleve esta página o su versión en PDF a su fisioterapeuta o terapeuta de mano para garantizar una rehabilitación coordinada.

Si tiene alguna duda o inquietud respecto a su herida después de la cirugía, comuníquese con nuestro consultorio. A menudo resulta útil tomar una fotografía de la herida y enviarla por correo electrónico para su evaluación.

Qué esperar

El cuidado de la herida se explica por separado: consulte la página de cuidado de heridas cuyo enlace se encuentra al final de este protocolo.

Los ejercicios siguientes son muy importantes para evitar que los tendones se adhieran mientras la herida cicatriza. En ocasiones, las articulaciones de los dedos pueden volverse rígidas tras esta intervención. Es fundamental prevenir esa rigidez desde el principio; por ello, se recomienda realizar estiramientos firmes y prolongados en los dedos (con la ayuda de la otra mano), especialmente para enderezarlos. Este tipo de estiramiento pasivo es seguro y no afecta la cirugía: el sistema de poleas ya se ha liberado, por lo que no hay nada en su interior que pueda verse afectado por el estiramiento.

Una vez que la herida haya cicatrizado, aplique calor a la mano durante 20 minutos antes de realizar estos ejercicios. Después de hacerlos, aplicar hielo puede ayudar a prevenir la inflamación.

En algunas ocasiones, la mano o la herida pueden volverse sensibles. Esto es normal, y se puede prevenir o minimizar iniciando desde el día siguiente a la cirugía una desensibilización diaria: toque o frote suavemente la zona de la herida (con el vendaje puesto). Este tipo de “retroalimentación sensorial” ayuda a que la piel vuelva a normalizar su respuesta al tacto y a la textura.

Durante las primeras 48 horas, procure reducir la hinchazón: mantenga la mano elevada, aplique hielo, use compresión si su terapeuta se lo ha indicado, y realice movimientos suaves de apertura y cierre de los dedos para favorecer la circulación y disminuir la inflamación.

Comience a utilizar la mano para tareas ligeras (vestirse, comer, etc.) tan pronto como el dolor lo permita, aumentando gradualmente la actividad. No exagere: si tras una actividad el dolor o la hinchazón aumentan notablemente, reduzca el esfuerzo hasta que la mano se calme y luego vaya aumentando de nuevo.

Una vez que la herida haya cicatrizado por completo, comience a masajear la cicatriz: realice círculos firmes sobre la incisión. En la página de cuidado de heridas encontrará más información sobre el manejo de cicatrices.

¿Qué dicen las evidencias sobre la recuperación?

La liberación abierta de la polea A1 es una intervención bien establecida, con un historial comprobado en la literatura médica. La interrupción del deslizamiento del tendón y el bloqueo de los movimientos se corrigen mediante la cirugía: una vez se divide la polea, el tendón vuelve a deslizarse libremente y, por lo general, el fenómeno no vuelve a aparecer. En una serie de casi 1.600 casos de liberación abierta, menos del 1 % de los pacientes necesitaron una segunda intervención por persistencia o recurrencia del problema; además, no se registraron lesiones nerviosas ni infecciones profundas [4]. Un estudio comparativo con un seguimiento de más de tres años también arrojó resultados similares: no hubo recurrencias tras la liberación abierta [5].

El dolor en la palma disminuye considerablemente durante la primera o segunda semana. En un estudio comparativo, el tiempo mediano para lograr una reducción significativa del dolor tras la liberación abierta fue de aproximadamente una semana [5]. No obstante, cierta sensibilidad al tacto al agarrar objetos, ligera hinchazón o rigidez digital pueden persistir varias semanas después; esto es normal y refleja el proceso de maduración de la cicatriz, que tarda unos tres meses [3]. El programa de desensibilización, masaje de cicatriz y ejercicios descrito en este documento está pensado precisamente para abordar esta fase. En la gran serie mencionada, aproximadamente uno de cada veinte dedos presentó algún problema postoperatorio; lo más frecuente fue rigidez temporal o sensibilidad cicatricial que mejoró con tratamiento. En personas con diabetes, la recuperación de la movilidad suele ser más lenta, por lo que el programa de ejercicios resulta aún más importante en este grupo [4].

Los protocolos publicados de terapia de la mano recomiendan iniciar ejercicios activos y pasivos de movilidad digital y deslizamiento tendinoso en los primeros días tras la cirugía; posteriormente, una vez cicatrizada la herida, se incorporan técnicas de manejo de la cicatriz y desensibilización, y más tarde se reintroducen ejercicios progresivos de fortalecimiento de la prensión [2][3]. Este enfoque escalonado coincide con el programa descrito en esta página. Iniciar los ejercicios a tiempo es clave para mantener el deslizamiento tendinoso y la flexibilidad articular mientras la herida sana.

El regreso al trabajo depende de las exigencias laborales de cada persona. En un estudio comparativo, la mitad de los pacientes volvió a trabajar al cabo de unas dos semanas tras la liberación abierta [5]; quienes desempeñan labores ligeras o de oficina suelen recuperarse antes, mientras que en trabajos manuales pesados se debe esperar hasta que desaparezcan las restricciones de levantamiento y agarre.

Un ensayo controlado aleatorizado comparó tres meses de terapia supervisada tras la liberación abierta con un programa de ejercicios domiciliarios autogestionado: a los seis meses, la función general, la movilidad y el dolor fueron similares en ambos grupos; sin embargo, la fuerza de prensión mejoró más con la terapia supervisada. Los pacientes que obtuvieron mayores beneficios fueron aquellos con síntomas de bloqueo tendinoso presentes desde hacía más de doce meses antes de la cirugía, así como quienes realizaban tareas domésticas o labores ligeras [1]. En la práctica, un programa domiciliario bien ejecutado (los ejercicios de esta página) basta para la mayoría de los pacientes; la terapia especializada resulta útil cuando el dedo estuvo rígido durante mucho tiempo antes de la intervención o cuando la recuperación avanza lentamente.

Precauciones y limitaciones

Se recomienda un uso funcional moderado de la mano para tareas cotidianas como el aseo personal, la alimentación, vestirse, escribir y teclear. Estos son los límites a respetar:

  • Evite levantar objetos, agarrar cosas o soportar peso durante las primeras 4 semanas postoperatorias.
  • La conducción está restringida durante la primera semana; puede reanudarse cuando el dolor lo permita, cuando pueda cerrar el puño por completo y cuando pueda controlar el vehículo de forma segura.

Para su fisioterapeuta:

Manejo

  • Programa de ejercicios en casa según las tarjetas adjuntas: estiramientos de flexión/extensión de la muñeca; bloqueo de las articulaciones DIP (interfalángica distal) y PIP (interfalángica proximal); deslizamientos tendinosos (Serie A y Serie B).
  • Realizar estiramientos pasivos firmes y prolongados de los dedos, especialmente en extensión, para prevenir tempranamente la rigidez articular.
  • Aplicar calor en la mano durante 20 minutos antes de los ejercicios, una vez que la herida haya cicatrizado; aplicar hielo después de los ejercicios para evitar inflamación.
  • Iniciar de inmediato, tras la cirugía, la desensibilización diaria (golpecitos suaves o frotamiento sobre la herida, con el vendaje puesto).
  • Control de la hinchazón durante las primeras 48 horas: elevar la mano, aplicar hielo, compresión según sea necesario y realizar movimientos de bombeo con los dedos.
  • Retorno gradual al uso funcional moderado según lo permita el dolor, vigilando la aparición de dolor o hinchazón después de la actividad.
  • Masaje de la cicatriz (círculos firmes sobre la incisión) una vez que la herida haya cicatrizado por completo.

Precauciones

  • Únicamente uso funcional moderado para tareas cotidianas (aseo personal, alimentación, vestirse, escribir, teclear).
  • No levantar objetos, agarrar cosas ni soportar peso durante las primeras 4 semanas postoperatorias.
  • La conducción está restringida durante la primera semana; puede reanudarse cuando el dolor lo permita, cuando pueda cerrar el puño por completo y cuando pueda controlar el vehículo de forma segura.

Hitos esperados (basados en criterios y protocolos publicados [1][2][3])

  • El dolor se reduce a niveles tolerables con analgésicos simples en el plazo de 1–2 semanas [5].
  • La herida cicatriza y se inician el masaje de la cicatriz y la desensibilización a las 2–3 semanas [2][3].
  • Se logra flexión y extensión activa completa de los dedos (puño completo y extensión total) alrededor de la semana 3, manteniéndose gracias al programa de bloqueo y deslizamientos tendinosos [2].
  • Se introduce, tras transcurridas las 4 semanas de precaución, el fortalecimiento gradual de la prensión y el agarre (por ejemplo, con plastilina), progresando hacia un uso funcional pleno.
  • Considerar la derivación a terapia de mano supervisada si el paciente presentaba síntomas previos a la cirugía desde hacía más de 12 meses, si su actividad laboral implica un uso constante y delicado de la mano, o si la recuperación del rango de movimiento o de la fuerza de agarre es lenta [1].

Estos son los ejercicios descritos en el folleto, que debe realizar después de la cirugía y continuar en casa bajo la guía de su fisioterapeuta o terapeuta de mano.

Sus ejercicios

Estos son los ejercicios que aparecen en su folleto. Comience a realizarlos únicamente bajo la guía del Dr. Hirpara y de su terapeuta especializado en mano, respetando siempre los rangos y límites que le hayan indicado. La serie de deslizamientos tendinosos y los ejercicios de bloqueo ayudan a que el tendón liberado se mueva libremente dentro de su vaina, evitando así que se adhiera a la cicatriz en proceso de curación; esto impide que la rigidez reaparezca como consecuencia de dicha adherencia. Los ejercicios de extensión activa y pasiva aseguran que el dedo se estire por completo; los movimientos de oposición del pulgar restablecen la capacidad de pellizcar, y los estiramientos de la muñeca previenen su rigidez mientras el foco del tratamiento son los dedos. Es normal sentir sensibilidad directamente sobre la cicatriz en la palma durante algunas semanas. Interrumpa cualquier ejercicio que le provoque dolor intenso.

Después de seguir el protocolo

Este protocolo se redactó en colaboración con Sarah Farrell, BOccThy (Licenciada en Terapia Ocupacional) y Terapeuta de Mano Acreditada; incorpora las guías actualizadas para el manejo postquirúrgico (abril de 2025) elaboradas por Ruby Doolan, Terapeuta de Mano Acreditada de Extend Rehabilitation. Complementa los consejos generales de recuperación que ofrece la consulta: consulte manejo del dolor postoperatorio, cuidado de la herida y conceptos básicos de la terapia de mano. Para información sobre la intervención quirúrgica en sí, consulte liberación de dedo en gatillo.

El marco conceptual y los hitos de recuperación se basan, además, en protocolos publicados para la rehabilitación tras la liberación de dedo en gatillo, entre ellos los del University of Virginia Hand Center y Twin Cities Orthopedics; así como en estudios publicados sobre resultados tras dicha cirugía, como un ensayo controlado aleatorizado sobre rehabilitación postoperatoria (Saito et al., Journal of Clinical Medicine, 2023) y un amplio estudio sobre eventos adversos (Bruijnzeel et al., Journal of Hand Surgery, 2012).

Referencias

[1] Saito T, Nakamichi R, Nakahara R, Nishida K, Ozaki T. Eficacia de la rehabilitación tras la liberación quirúrgica abierta del dedo en gatillo: estudio prospectivo, aleatorizado y controlado. J Clin Med. 2023;12(22):7187. https://pmc.ncbi.nlm.nih.gov/articles/PMC10671987/ [2] University of Virginia Hand Center. Guías para la liberación del dedo en gatillo (protocolo de terapia postoperatoria). https://med.virginia.edu/orthopaedic-surgery/wp-content/uploads/sites/242/2015/11/Triggerfingerreleaseprotocol.pdf [3] Meletiou SD, Twin Cities Orthopedics. Manejo postoperatorio de la liberación del dedo en gatillo (liberación de la polea A1). https://tcomn.com/wp-content/uploads/2017/10/Trigger-Release-A1.pdf [4] Bruijnzeel H, Neuhaus V, Fostvedt S, Jupiter JB, Mudgal CS, Ring DC. Eventos adversos tras la liberación abierta de la polea A1 en casos de dedo en gatillo idiopático. J Hand Surg Am. 2012;37(8):1650–1656. https://pubmed.ncbi.nlm.nih.gov/22763058/ [5] Chanthanapodi P, Aodsup S. Resultados comparativos entre la cirugía percutánea y la cirugía abierta para el dedo en gatillo: análisis mediante puntuación de propensión. Front Surg. 2025;12:1509292. https://pmc.ncbi.nlm.nih.gov/articles/PMC11922895/

Reviewed by Dr Kieran Hirpara · 10 June 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Trigger Finger Release (A1 Pulley Release) — Surgical Outcomes & Post-operative Rehabilitation

Topic scope: (A) the place of surgery in stenosing tenosynovitis (trigger finger/thumb) after failed conservative care (splinting, corticosteroid injection), and (B) post-operative rehabilitation after surgical division of the A1 pulley — open or percutaneous. This is an early-motion pathway: nothing is reconstructed, the catching is mechanically abolished the moment the pulley is divided, and the rehab exists to keep the now-free tendon gliding and the finger joints supple while the wound heals.

Defining principle of the rehab here: A1 pulley release removes the obstruction; it does not create a construct that needs protecting. Once the pulley is divided the flexor tendon glides freely and triggering does not usually recur. So — unlike a tendon repair, and like a carpal-tunnel decompression — the pathway is immediate active motion: full active finger flexion/extension and tendon glides from the first days, oedema and scar care, early light functional use, and a quick return. Most patients need no formal hand therapy at all; supervised therapy is reserved for the minority with pre-existing joint stiffness, long-standing triggering, or slow recovery. The single branch point is whether the finger was already stiff before surgery (long-standing fixed flexion / PIP contracture) — those patients need active therapy to recover motion the release alone cannot restore.

A. WHERE SURGERY SITS IN THE PATHWAY

Trigger finger is usually managed non-operatively first: activity modification, splinting, and corticosteroid injection, which resolves a substantial proportion of digits without surgery. Surgery (A1 pulley release) is reserved for digits that fail injection, recur, or present with a fixed deformity. The corpus contains the comparative evidence underpinning this stepped approach (percutaneous release vs steroid injection; one- vs two-injection regimens; corticosteroid solution choice) — Moderate (RCT). The rehab protocol on the patient page begins after that decision has been made, so this brief concentrates on the surgical and post-surgical evidence.

B. SURGICAL OUTCOMES & RESOLUTION RATES

Open release of the A1 pulley is one of the most reliable operations in hand surgery. The mechanical problem — a thickened tendon catching under a tight pulley — is solved by dividing the pulley, and the result is durable:

  • In a series of 1,598 open releases, fewer than 1% required a second operation for persistent or recurrent triggering, with no nerve injuries and no deep infections [Bruijnzeel 2012]. About one digit in twenty had a documented post-operative problem, almost all minor and self-limiting (transient stiffness, scar tenderness). Strong (large cohort).
  • Recovery of motion is slower in patients with diabetes, reinforcing the value of the exercise program in that group [Bruijnzeel 2012]. Moderate.
  • A propensity-matched comparison with >3 years follow-up found no recurrences after open release, with median time to significant pain reduction of about one week and roughly half of patients back at work within ~2 weeks [Chanthanapodi 2025]. Moderate.

Take-home for rehab: because the operation itself abolishes the triggering, the rehabilitation is not "earning back" a surgical result — it is preventing the two things that can go wrong during healing: tendon adhesion and joint stiffness. Early glide and early extension are the levers.

C. OPEN vs PERCUTANEOUS RELEASE

Both techniques divide the same structure and converge to the same place.

  • A Level I meta-analysis of 8 RCTs (548 patients) found no significant difference between open and percutaneous release in revision, complication, or pain rates — both are appropriate options [Casey 2024, J Hand Surg Am]. Strong (meta-analysis of RCTs).
  • Larger RCT syntheses show percutaneous release confers faster early functional recovery — better short/mid-term Q-DASH, ~12 days earlier return to work, and shorter analgesic use — while long-term function, grip, motion and complication/revision rates are equivalent. Strong.
  • Percutaneous (including ultrasound-guided/sonographically-controlled) technique is supported by multiple corpus series for efficacy and safety, with the main theoretical risks being incomplete release and digital nerve proximity, mitigated by surface landmarks and imaging [corpus percutaneous series]. Moderate.

Rehab implication: the post-operative program is essentially the same for both approaches — early active motion, glides, oedema and scar care. The patient page applies regardless of whether the release was open or percutaneous; percutaneous patients simply tend to be comfortable and back to activity a little sooner.

D. THE ROLE — AND LIMITS — OF POST-OPERATIVE HAND THERAPY

This is the central evidence point for the protocol, and it is one where "more therapy" is not automatically better.

  • A prospective RCT compared 3 months of supervised rehabilitation after open release against a self-directed home exercise program: at six months, overall function, motion and pain were similar between groups. Supervised therapy added further grip-strength recovery, and the patients who clearly benefited from formal therapy were those whose **triggering had been present

    12 months pre-operatively and those in housework/lighter-work roles [Saito 2023, J Clin Med]. Moderate (single RCT).

  • Published surgeon and hand-therapy protocols (e.g. University of Virginia Hand Center; Twin Cities Orthopedics) start active and passive finger motion and tendon glides within the first days, add scar massage and desensitisation once the wound is healed, and reintroduce graded grip strengthening later — precisely the staged structure of the patient page. Consensus.

Bottom line: a well-performed home program carries most patients through. Formal hand therapy is reserved, not routine — escalate it for long-standing pre-operative triggering, pre-existing joint stiffness/contracture, manual or fine-use occupational demands, or slow motion/grip recovery.

E. COMPLICATIONS

Serious complications are uncommon (roughly <1–4% across series) and most "complications" are minor, self-limiting healing phenomena:

  • Digital nerve injury — the most feared complication, particularly relevant to percutaneous technique (blind division near the radial digital nerve of the thumb and index) and to scar/retraction in open release. Rare in experienced hands; transient paraesthesia is more common than true division [corpus complication series]. Moderate.
  • Incomplete release / persistent triggering — failure to fully divide the A1 pulley (or an A2/FDS slip contribution); a recognised cause of revision, more often discussed with percutaneous technique. Moderate.
  • Recurrent triggering — uncommon after adequate open release (<1% reoperation in the 1,598-digit series) [Bruijnzeel 2012]. Strong.
  • Infection — usually superficial; deep infection rare (none in the large open series) [Bruijnzeel 2012]. Strong.
  • Bowstringing — a rare complication from excessive proximal pulley loss (A1 plus encroachment on A2); largely avoided by limiting division to A1 [bowstringing case literature]. Weak (case-level).
  • Stiffness / flexion contracture / "flare" — the commonest self-limiting problem; transient PIP stiffness, scar tenderness and a post-operative inflammatory flare that settle with the motion, desensitisation and scar program. Recovery is slower in diabetes. Moderate. This is the category the rehabilitation program actively targets.

F. PHASED POST-OP TIMELINE (matches the patient protocol)

Phase Window Protection Motion / use Therapy add-ons Notes
I — Immediate active motion & oedema control Day 0–2 None beyond dressing Active finger flexion/extension and finger "pumps" from day 1; tendon glides commenced Elevation, ice, compression if provided; desensitisation (tap/rub over dressed wound) from day 1 Nothing reconstructed -> motion is the priority; manage swelling actively
II — Glide & joint motion Week 0–2 None Tendon glides (Series A/B), DIP & PIP blocking, composite extension; firm passive stretch into extension Continue desensitisation Goal: keep tendon gliding, prevent adhesion & stiffness; pain settles substantially (~1 wk) [Chanthanapodi 2025]
III — Scar maturation & function Week 2–4 Light functional use only Full active fist + full composite extension by ~3 wk; build light daily-living use Scar massage (firm circles) once wound healed; heat before / ice after exercises No lifting/gripping/weight-bearing to ~4 wk; driving limited ~first week (full fist + safe control)
IV — Strengthening & return Week 4+ None Graded grip/pinch (e.g. putty) once 4-wk precaution lifts -> full function Supervised therapy if indicated (long-standing trigger, stiffness, slow recovery, occupational demand) [Saito 2023] Manual workers return later than desk/light roles

Timings are criteria-based and drawn from published surgeon/hand-therapy protocols; they are typical, not trial-mandated.

G. KEY CONTROVERSIES / EVIDENCE QUALITY

  1. Is routine post-op hand therapy necessary? The best available evidence (Saito 2023 RCT) says no for most — home exercise matches supervised therapy on function/pain/motion at six months, with supervised therapy adding grip strength and benefiting a defined subgroup (long-standing trigger, lighter-work roles). The protocol's "therapy reserved, not routine" stance is evidence-aligned. Moderate.
  2. Open vs percutaneous. Equivalent long-term outcomes and safety (Casey 2024 meta-analysis); percutaneous offers faster early recovery. The rehab is the same either way. The live debate is technique-side (nerve safety, completeness of release), not rehab-side. Strong on equivalence.
  3. The rehab protocol structure itself is consensus/expert, built from surgeon patient-guidance documents plus one rehabilitation RCT — there is no large trial dictating exact phase timings.
  4. Diabetes modifies recovery — slower motion recovery and a lower threshold to involve a hand therapist; not a different protocol, a different pace. Moderate.

H. EVIDENCE STRENGTH FLAGS (summary)

  • STRONG (meta-analysis / RCTs / large cohort): open vs percutaneous equivalence in revision/complication/pain (Casey 2024, 8 RCTs); percutaneous faster early functional recovery (RCT syntheses); durability of open release (<1% reoperation, no nerve injury/deep infection in 1,598 digits, Bruijnzeel 2012).
  • MODERATE (single RCT / cohorts): home exercise ~ supervised therapy at 6 months with grip-strength edge for supervised therapy (Saito 2023); percutaneous efficacy/safety series; slower recovery in diabetes; injection-vs- surgery comparative data.
  • WEAK / CONSENSUS: the post-operative rehabilitation protocol structure and exact phase timings (surgeon/hand-therapy patient-guidance documents); bowstringing risk (case-level).

CITATIONS

RAG corpus (180,000+ Orthopaedic articles)

  • Open Versus Percutaneous Fixation of Trigger Finger: Meta-Analysis of Clinical Outcomes. J Hand Surg Am. 2024. DOI: 10.1016/j.jhsa.2024.03.010
  • Complications of Open Trigger Finger Release. J Hand Surg Am. 2010. DOI: 10.1016/j.jhsa.2009.12.040
  • Differential Pulley Release in Trigger Finger: A Prospective, Randomized Clinical Trial. Hand (N Y). 2021. DOI: 10.1177/1558944721994231
  • Percutaneous A1 pulley release vs steroid injection for trigger digit. J Hand Surg Eur. 2010. DOI: 10.1177/1753193410381824
  • Comparative Study of A1 Pulley Release and Ulnar Superficialis Slip Resection in Trigger Finger. J Hand Surg Am. 2022. DOI: 10.1016/j.jhsa.2022.04.021
  • Risk Factors for Requiring Ulnar Superficialis Slip Resection During Trigger Finger Release. J Hand Surg Am. 2024. DOI: 10.1016/j.jhsa.2024.08.013
  • Impact of Flexor Tendon Traction Tenolysis on Clinical Outcomes in Open A1 Pulley Release. J Hand Surg Glob Online. 2024. DOI: 10.1016/j.jhsg.2024.09.010
  • Ultrasound-Assisted Percutaneous Trigger Finger Release: Is It Safe? Hand (N Y). 2008. DOI: 10.1007/s11552-008-9137-8
  • Evaluation of Percutaneous First Annular Pulley Release: Efficacy and Complications. J Hand Surg Am. 2016. DOI: 10.1016/j.jhsa.2016.04.009
  • Sonographically controlled minimally-invasive A1 pulley release using a new guide. BMC Musculoskelet Disord. 2023. DOI: 10.1186/s12891-023-06982-x
  • Percutaneous A1 pulley with corticosteroid injection for trigger finger release. J Orthop Surg Res. 2025. DOI: 10.1186/s13018-025-05776-2
  • A Cost and Efficiency Analysis of the WALANT Technique for the Management of Trigger Finger. Plast Reconstr Surg Glob Open. 2019. DOI: 10.1097/gox.0000000000002509
  • Management of Pediatric Trigger Thumb and Trigger Finger. J Am Acad Orthop Surg. 2012. DOI: 10.5435/jaaos-20-04-206
  • What's New in Hand Surgery. J Bone Joint Surg Am. 2024. DOI: 10.2106/jbjs.23.01343

Trigger finger surgical & rehabilitation literature (URLs)

  • Saito T, et al. The Effectiveness of Rehabilitation after Open Surgical Release for Trigger Finger: A Prospective, Randomized, Controlled Study. J Clin Med. 2023;12(22):7187. https://pmc.ncbi.nlm.nih.gov/articles/PMC10671987/
  • Bruijnzeel H, et al. Adverse Events of Open A1 Pulley Release for Idiopathic Trigger Finger. J Hand Surg Am. 2012;37(8):1650-1656. https://pubmed.ncbi.nlm.nih.gov/22763058/
  • Casey JC, et al. Open Versus Percutaneous Fixation of Trigger Finger: Meta-Analysis of Clinical Outcomes. J Hand Surg Am. 2024;49(6):570-575. https://pubmed.ncbi.nlm.nih.gov/38727666/
  • Chanthanapodi P, Aodsup S. Comparative results of percutaneous and open surgery for trigger fingers: a propensity score analysis. Front Surg. 2025;12:1509292. https://pmc.ncbi.nlm.nih.gov/articles/PMC11922895/
  • Complications of Percutaneous Release of the Trigger Finger. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC6485534/
  • Trigger Finger. StatPearls, NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK459310/
  • Bowstringing as a complication of trigger finger release. J Hand Surg Am. 1988. https://www.jhandsurg.org/article/S0363-5023(88)80097-2/abstract
  • Trigger Finger (patient information). British Society for Surgery of the Hand (BSSH). https://www.bssh.ac.uk/patients/conditions/15/trigger_finger

Published rehab protocols (patient-guidance — basis for the phase structure)

  • University of Virginia Hand Center. Trigger Finger Release Guidelines (post-operative therapy protocol). https://med.virginia.edu/orthopaedic-surgery/wp-content/uploads/sites/242/2015/11/Triggerfingerreleaseprotocol.pdf
  • Meletiou SD, Twin Cities Orthopedics. Post-operative Management of Trigger Release (A1 pulley release). https://tcomn.com/wp-content/uploads/2017/10/Trigger-Release-A1.pdf
  • EmergeOrtho. Trigger Finger Release - Post-operative Instructions. https://emergeortho.com/wp-content/uploads/2022/06/Trigger-Finger-Release.pdf

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NC NonCommercial — not for commercial use

Attribution-NonCommercial 4.0 International

Creative Commons Corporation ("Creative Commons") is not a law firm and does not provide legal services or legal advice. Distribution of Creative Commons public licenses does not create a lawyer-client or other relationship. Creative Commons makes its licenses and related information available on an "as-is" basis. Creative Commons gives no warranties regarding its licenses, any material licensed under their terms and conditions, or any related information. Creative Commons disclaims all liability for damages resulting from their use to the fullest extent possible.

Using Creative Commons Public Licenses

Creative Commons public licenses provide a standard set of terms and conditions that creators and other rights holders may use to share original works of authorship and other material subject to copyright and certain other rights specified in the public license below. The following considerations are for informational purposes only, are not exhaustive, and do not form part of our licenses.

Considerations for licensors: Our public licenses are intended for use by those authorized to give the public permission to use material in ways otherwise restricted by copyright and certain other rights. Our licenses are irrevocable. Licensors should read and understand the terms and conditions of the license they choose before applying it. Licensors should also secure all rights necessary before applying our licenses so that the public can reuse the material as expected. Licensors should clearly mark any material not subject to the license. This includes other CC- licensed material, or material used under an exception or limitation to copyright. More considerations for licensors: wiki.creativecommons.org/Considerations_for_licensors

Considerations for the public: By using one of our public licenses, a licensor grants the public permission to use the licensed material under specified terms and conditions. If the licensor's permission is not necessary for any reason--for example, because of any applicable exception or limitation to copyright--then that use is not regulated by the license. Our licenses grant only permissions under copyright and certain other rights that a licensor has authority to grant. Use of the licensed material may still be restricted for other reasons, including because others have copyright or other rights in the material. A licensor may make special requests, such as asking that all changes be marked or described. Although not required by our licenses, you are encouraged to respect those requests where reasonable. More considerations for the public: wiki.creativecommons.org/Considerations_for_licensees

Creative Commons Attribution-NonCommercial 4.0 International Public License

By exercising the Licensed Rights (defined below), You accept and agree to be bound by the terms and conditions of this Creative Commons Attribution-NonCommercial 4.0 International Public License ("Public License"). To the extent this Public License may be interpreted as a contract, You are granted the Licensed Rights in consideration of Your acceptance of these terms and conditions, and the Licensor grants You such rights in consideration of benefits the Licensor receives from making the Licensed Material available under these terms and conditions.

Section 1 -- Definitions.

a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

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