The Safety and Efficacy of Percutaneous Trigger Finger Release Under Local Anaesthesia
Keywords:
Percutaneous release, Trigger finger, Tendon, Stenosing tenosynovitis, Local anaesthesiaAbstract
Objective:To determine the safety and efficacy of trigger finger and thumb released percutaneously with an 18 gauge needle
under local anaesthesia.
Materials and Methods: This descriptive case series study was conducted at Orthopaedic and Traumatology Unit “A” Medical
Teaching Institution(MTI) Lady Reading Hospital (LRH) Peshawar Pakistan from April 2014 to December 2015.All patients
of trigger finger or thumb of either gender fulfilling the inclusion criteria were percutaneously released under local anaesthesia
with the tip of an 18-gauge hypodermic needle.Post operative assessment of these patients was done weekly for a month and
then monthly for 6 months. Clinical results were evaluated in terms of pain, activity level and patient satisfaction after 6 months
at follow up and rated as excellent, good and poor.
Results:Thirty two fingers in twenty five patients with mean age 38.28 years±11SD (range 18 to 62 years) were included in
the study. Post operatively excellent results were achieved in 90.9%(20/22) patients and good in 9%(2/22) patients at six months
follow up. There were only 3(9.3%) failed releases requiring conversion to open release. There was no recurrence of trigger
finger and no digital nerve nor tendon injuries reported.
Conclusion:Percutaneous trigger finger release under local anaesthesia is a safe and highly effective method for releasing
trigger fingers. We recommend it as a treatment of choice for established trigger finger or thumb.
References
Clapham PJ, Chung KC. A historical perspective of the Notta’s node in trigger fingers. J HandSurg Am. 2009; 34:1518-22
Dierks U,Hoffmann R, Meek MF. Open versus percutane- ous release of the A1-pulleyfor stenosing tenovaginitis: A perspective randomized trial. Tech Hand Up Extrem-Surg.2008;12:183-7
Moore JS. Flexor tendon entrapment of the digits(trigger finger and trigger thumb).J Occup Environ Med.2000;42: 526-45
Sbernardori MC, Bandiera P. Histopathology of the A1 pulley in adult trigger fingers. J Hand Surg Eur 2007;32: 554-6
Saldana MJ.Trigger digits:Diagnosis and treatment.J Am Acad Orthop Surg.2000;9:246-52
McAuliffe JA.Tendon disorders of the hand and wrist. J Hand Surg Am.2010;35:846-53
Dhal J,Hammert WC.Overview of injectable corticoste- roids.J Hand Surg Am. 2012;37:1715-7
Lorthioir J. Surgical treatment of trigger-finger by a sub- cutaneous method.J Bone Joint Surg Am.1958;40:793- 5
Ryzewicz M,Wolf JM.Trigger digits:Principles, manage- ment and complications.J Hand Surg Am.2006;31:135- 46
Gilberts EC, BeekmanWH,StevensHJ,Wereldsma JC. Prospective randomized trial of open versus percutaneous surgery for trigger digits. J Hand Surg Am.2001;26:497- 500
Blumberg N, Arbel R, Dekel S. Percutaneous release of trigger digits. J Hand Surg Br.2001;26:256-7
Sahu RL,Gupta P. Experience of percutaneous trigger finger release under local anaesthesia in the Medical College of Mullana,Haryana Ambala. Ann Med Health Sci Res.2014;4(5):806-9
Quinnell RC.Conservative management of trigger finger. Practitioner. 1980;224:187-90
Grundberg AB, Dobson JF. Percutaneous release of the
common extensor origin for tennis elbow.Clin Orthop Relat Res.2000;376:137-40
Wilhelmi BJ, Mowlavi A, Neumeister MW,Bueno R, Lee WP. Safe treatment of trigger finger with longitudinal and transverse landmarks:An anatomic study of the bor- der fingers for percutaneous release. Plast Reconstr Surg. 2003;112:993-9
Eastwood DM,Gupta KJ,Johnson DP.Percutaneous rele- ase of the trigger finger:An office procedure.J Hand Surg. 1992;17:114-7
Ha KI,Park MJ,Ha CW.Percutaneous release of trigger digits.J Bone Joint Surg.2001;83:75-7
Ucar BY.Percutaneous surgery:A safe procedure for tri- gger finger? N Am J Med Sci.2012;4(9):401-3
Park MJ,OH I,Ha KI.A1 pulley release of locked trigger digit by percutaneous technique. J Hand Surg Br.2004;29 (5):502-5
Mishra SR, Gaur AK,Choudhary MM,Ramesh J. Percut- aneous A1 pulley release by the tip of a 20 G hypodermic needle before open surgical procedure in trigger finger management. Tech Hand Up Extrem Surg.2013;17 (2): 112-5
Dahabra IA,Sawaqed IS.Percutaneous trigger finger release with 18 gauge needle.Saudi Med J.2007;28(7)
:1065-7
Gilberts EC,Wereldsma JC.Long term results of percutan- eous and open surgery for trigger fingers and thumb.Int Surg.2002;87(1):48-52
Fu YC, Huang PJ, Tien YC, Lu YM, Fu HH, Lin GT. Revision of incompletely released trigger fingers by percutaneous release: Results and complications. J Hand SurgAm.2006.31;1288-91
Guler F,Kose O,Ercan EC,Turan A,Canbora K. Open versus percutaneous release for the treatment of trigger thumb.Orthopaedics.2013;36(10):1290-4
Maneerit J,Sriworakun C,Budhraja N, Nagavajara P. Trigger thumb:Results of a prospective randomized stu- dy of percutaneous release with steroid injection versus steroid injection alone. J Hand Surg Br.2003;28:586-9
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Copyright (c) 2016 Abdur Rehman Qureshi, Faaiz Ali Shah, Shahab-ud- Din, Wali Muhammad Khan
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