Dr MB Nitheesh CONSULTANT ORTHOPAEDIC, ARTHROSCOPIC & JOINT REPLACEMENT SURGEON
Surgery may be recommended if symptoms are severe or do not improve with non-operative management. The goal of surgery is to release the tendon sheath to make more room for the irritated tendons. When done correctly, this can relieve the symptoms of De Quervain's tenosynovitis without impacting hand/wrist function.
During surgery, the surgeon first identifies and protects the nerves that live near the tendon sheath. The surgeon then releases the sheath in a way that avoids tendon instability. If there is excess tissue (tenosynovium) around the tendons, the surgeon will remove it. The incision is then closed, and a bandage (and sometimes a splint) is applied.
surgical procedure. The surgical procedure for trigger finger is called “tenolysis” or “trigger finger release.”
The goal of the procedure is to release the A1 pulley that is blocking tendon movement so the flexor tendon can glide more easily through the tendon sheath. Typically, the procedure is done in an outpatient setting with an injection of local anesthesia to numb the area for surgery.
Surgery is performed through either a small open incision in the palm or with the tip of a needle. The A1 pulley is divided (released) so that the flexor tendon can glide freely. Although pulleys have an important function in the hand, releasing the A1 pulley should not cause problems in the future.
Open carpal tunnel release.
In an open carpal tunnel release surgery, your doctor makes a small incision in the palm of your hand and views the inside of your hand and wrist through this incision. During the procedure, your doctor will divide the transverse carpal ligament (the roof of the carpal tunnel). This increases the size of the tunnel and decreases pressure on the median nerve.
After surgery, the ligament may gradually grow back together in a lengthened fashion, but there will be more space in the carpal tunnel, and pressure on the median nerve will be relieved.
Endoscopic carpal tunnel release.
In endoscopic surgery, your doctor makes one or two smaller skin incisions (called portals) and uses a miniature camera, or endoscope, to see inside your hand and wrist. A special knife is used to divide the transverse carpal ligament, similar to the open carpal tunnel release procedure.