Limited evidence for benefits of open surgery for trigger finger

Limited evidence for benefits of open surgery for trigger finger

Brian McAvoy
Clinical question

Compared with steroid injections, how effective is open surgery for trigger finger?

Bottom line

Low-quality evidence indicated that, compared with steroid injection, open surgical treatment in people with trigger finger might result in a lower recurrence rate from 6 up to 12 months following the treatment, although it increased the incidence of pain during the first follow-up week. There was uncertainty about the effect of open surgery with regard to the resolution rate in follow-up at 6 to 12 months, compared with steroid injections, due to high heterogeneity and few events occurring in the trials; there was uncertainty too about the risk of adverse events and neurovascular injury because of the few events occurring in the studies. The age range of participants included in the studies was 16 to 88 years, and the majority were women (approximately 70%). The average duration of symptoms ranged from 3 to 15 months, and the follow-up after the procedure ranged from 8 weeks to 23 months.


Hand function or participant satisfaction were not reported.


Trigger finger is a common clinical disorder characterised by pain and catching as the patient flexes and extends digits because of disproportion between the diameter of flexor tendons and the first annular pulley. The treatment approach may include non-surgical or surgical treatments. Currently, there is no consensus about the best surgical treatment approach (open, percutaneous or endoscopic).

Cochrane Systematic Review

Fiorini HJ et al. Surgery for trigger finger. Cochrane Reviews, 2018, Issue 12. Art. No.: CD009860.DOI: 10.1002/14651858. CD009860.pub2. This review contains 14 studies involving 1260 participants, with 1361 trigger fingers.