DATE OF OPERATION: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS: Right thumb trigger finger.
POSTOPERATIVE DIAGNOSIS: Right thumb trigger finger.
OPERATION PERFORMED: Right thumb trigger release.
SURGEON: John Doe, MD
ASSISTANT: Jane Doe, MD
ANESTHESIA: Local.
COMPLICATIONS: None.
ESTIMATED BLOOD LOSS: Minimal.
INDICATIONS FOR OPERATION: The patient is a (XX)-year-old female with triggering of her right thumb with occasional locking. The patient has failed nonoperative treatments, and informed consent was obtained for release of this trigger finger.
DESCRIPTION OF OPERATION: The patient was brought to the OR and laid supine on the OR table. A tourniquet was placed on the right forearm. Local anesthetic, including a 7 mL of mixture of Marcaine and lidocaine, was injected into the base of volar aspect of her thumb in the area of the incision.
Next, the right hand was prepped and draped in the usual sterile fashion. An Esmarch bandage was used to exsanguinate and then the tourniquet was inflated to 275 mmHg. Next, an approximately 1.5 cm transverse incision was made at the volar base of the thumb over the region of the A1 pulley.
Dissection was carried out bluntly down to expose the A1 pulley over the FPL tendon. The A1 pulley was identified and incised with knife longitudinally. The tendon was then noted to be free after the release, and throughout range of motion of the thumb, there was no longer any catching or locking.
After adequate release of the A1 pulley, the wound was then thoroughly irrigated with normal saline. The patient was also asked to actively extend and flex her thumb, and she no longer noted any catching, locking, or triggering. The wound was then closed with 5-0 nylon suture in horizontal mattress fashion. Sterile dressings were applied. The tourniquet was deflated prior to closure. Tourniquet time was 6 minutes. The patient was then transferred back onto a stretcher and taken to the PACU for recovery.
