Trigger finger release without an incision: thread vs open surgery vs injection
There are three common treatments for a trigger finger: a cortisone injection, open trigger finger release through a small palm incision, and Thread Trigger Finger Release, a less invasive alternative to trigger finger surgery with no incision and no stitches.
Dr. Jesse Dashe performs all three in San Leandro, and he is the only surgeon in the San Francisco Bay Area offering Thread Release.
Side-by-side comparison
| Factor | Thread release | Open release | Cortisone injection |
|---|---|---|---|
| What it does | Releases the A1 pulley with a thread | Releases the A1 pulley through an incision | Calms inflammation around the tendon; nothing is released |
| Incision | None, two needle punctures | Small incision in the palm | None, one injection |
| Stitches | None, two bandaids | Yes, removed at a follow-up visit | None |
| Anesthesia | Local only, you are awake | Local, sometimes with sedation | None or a little local |
| Where | In the office | Office procedure room or surgery center | In the office |
| Guidance | Real-time ultrasound | Direct view through the incision | By feel or ultrasound |
| Thumb | Fingers only, not the thumb | Fingers and thumb | Fingers and thumb |
| Evidence | Cadaveric studies; clinical outcome studies not yet published | Long clinical track record | Widely used first-line treatment |
Why the ultrasound matters
A digital nerve and artery run along each side of the finger, close to the A1 pulley. Open release protects them by looking at them through the incision. Thread release replaces the incision with real-time ultrasound, so the nerve, artery, tendon and pulley are identified before the needle is placed and watched throughout.
See the procedure step by step in the Thread Trigger Finger Release animation.
Frequently Asked Questions
Is there a less invasive alternative to open trigger finger surgery?
Yes. Thread Trigger Finger Release releases the same A1 pulley as open surgery, but with a thread placed under ultrasound guidance through two small poke holes instead of an incision in the palm. There are no stitches, and it is done in the office under local anesthetic. Dr. Jesse Dashe in San Leandro is the only surgeon in the San Francisco Bay Area offering Thread Release.
Does thread release do the same thing as open surgery?
Both release the A1 pulley, the tight band that makes the finger catch or lock, and both leave the neighbouring A2 pulley intact. The difference is the route: open release works through a small palm incision; thread release works through two needle punctures under ultrasound.
What is the evidence for thread trigger finger release?
The thread technique for trigger finger has been validated in cadaveric, or anatomy lab, studies, which showed complete A1 pulley release without injury to the surrounding nerves, arteries or tendons. Clinical outcome studies of the thread technique on fingers have not yet been published. Open release has a long clinical track record, and Dr. Dashe performs both.
Should I try a cortisone injection first?
Often, yes. Many patients start with a cortisone injection, and Dr. Dashe's approach is conservative first. A release is considered when the catching or locking keeps coming back or stays painful.
Can a trigger thumb be treated with thread release?
No. Dr. Dashe offers thread release for the fingers, not the thumb. Trigger thumb is treated with injection or open release.
Which option is right for me?
That depends on your finger, how long it has been triggering and what you have already tried. At your visit Dr. Dashe examines the finger, reviews every option, and recommends the one he believes is right for you. Coverage varies by insurance plan; the office can verify your benefits.
Find out which option fits your finger
Same and next-day appointments in San Leandro.
Thread Trigger Finger Release | Trigger finger | Injection or surgery?