Post-Surgery Swelling and Concerns After Trigger Finger Surgery

Postoperative swelling after trigger finger surgery?

Hello Doctor: I underwent outpatient trigger thumb surgery on August 25.
After the doctor administered anesthesia, he used a needle for a few seconds and bent my thumb backward, saying it was okay and that I didn't need a follow-up appointment.
He prescribed pain medication to take if I experienced pain, and the nurse instructed me to apply pressure for 15 minutes.
I pressed for 40 minutes before going home, and about four hours later, I applied ice for 12 minutes.
I then immediately removed the bandage and noticed blood oozing from the wound, so I quickly re-applied the gauze and pressed for another 15 minutes.
The next morning, there was no bleeding, but I found that my thumb could not bend backward at all and was swollen.

1.
Doctor, at the time of the outpatient procedure, the doctor was able to bend my thumb backward.
Why is it swollen and unable to bend the next day?
2.
Does this indicate a failed surgery?
3.
Is postoperative rehabilitation necessary for this minimally invasive trigger thumb surgery?

candy, 40~49 year old female. Ask Date: 2023/08/26

Dr. Zhan Xian reply Orthopedics

It is recommended to return for a follow-up appointment with the attending (surgical) physician for evaluation, and to also inquire about rehabilitation-related questions.
Thank you.

Reply Date: 2023/08/26

More Info

After undergoing trigger finger surgery, it's common to have concerns about swelling and the functionality of your finger. Let's address your questions and provide some insights into the recovery process.

1. Swelling and Inability to Bend the Thumb: It's not unusual for swelling to occur after surgery, even if the procedure was minimally invasive. The swelling can be attributed to several factors, including the body's natural inflammatory response to surgery, fluid accumulation, and the trauma of the procedure itself. When the doctor bent your thumb during the procedure, it was likely to ensure that the tendon was functioning correctly at that moment. However, post-operative swelling can temporarily restrict movement, making it difficult to bend the thumb the following day. This is a normal part of the healing process, and while it can be concerning, it does not necessarily indicate a failure of the surgery.

2. Is This a Surgical Failure?: It's important to differentiate between normal post-operative symptoms and signs of surgical failure. The inability to bend your thumb and the swelling you are experiencing are typical after surgery. Surgical failure would typically present with severe pain, persistent bleeding, or signs of infection (such as increased redness, warmth, or discharge from the wound). If you are experiencing significant pain or if the swelling does not subside over the next few days, it would be advisable to consult your surgeon for a follow-up evaluation. They can assess your recovery and determine if any additional interventions are necessary.

3. Post-Surgery Rehabilitation: Even after minimally invasive procedures like trigger finger surgery, rehabilitation can be beneficial. While some patients may not require extensive physical therapy, gentle range-of-motion exercises can help restore function and reduce stiffness. Your surgeon may recommend specific exercises to perform at home, or they may refer you to a physical therapist who specializes in hand rehabilitation. Engaging in rehabilitation can help improve your thumb's mobility and function, and it is often an essential part of the recovery process.

Additional Considerations
- Ice and Elevation: Continuing to ice your thumb and keeping it elevated can help reduce swelling. Ice should be applied for 15-20 minutes at a time, several times a day, especially in the first few days post-surgery.

- Pain Management: If you are experiencing pain, follow your doctor's instructions regarding pain medication. Over-the-counter pain relievers can also be effective in managing discomfort.

- Monitoring for Complications: Keep an eye on your surgical site for any signs of complications, such as increased swelling, redness, warmth, or discharge. If you notice any of these symptoms, contact your healthcare provider.

- Patience in Recovery: Healing takes time, and it's essential to be patient with your recovery process. Each individual's healing timeline can vary based on factors such as the extent of the surgery, individual health conditions, and adherence to post-operative care instructions.

In summary, while your concerns are valid, the symptoms you are experiencing are common after trigger finger surgery. It is crucial to maintain open communication with your healthcare provider, follow their recommendations for care and rehabilitation, and monitor your recovery closely. If you have any further questions or if your symptoms worsen, do not hesitate to reach out to your surgeon for guidance.

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