Percutaneous A1 pulley release: A cadaveric study

Bain, Gregory I.; Turnbull, James; Charles, Makepeace; Roth, James H.; Richards, Richard S

doi:10.1016/s0363-5023(05)80430-7

Cited by 106 publications

(151 citation statements)

References 16 publications

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“…Bain et al used 14 Gauge Angiocath to percutaneously release 17 thumbs of cadavers and became successful in 10 thumbs. In the same study, they reported that during percutaneous release of the thumb, needle tip passes 2 mm closer to the digital nerves and for thumbs percutaneous release is a risky procedure [21]. In a cadaver study performed by Buldu et al, the researchers reported that since radial digital nerve crosses over the tendon of the thumb proximal to the A1 pulley, radial digital nerve is under the risk of injury during percutaneous release procedures.…”

Section: Discussionmentioning

confidence: 98%

Percutaneous surgery using Admix NoKorTM Non-Coring 16 G needle in cases with trigger finger

Kurt¹,

Kalender²,

Sevimli³

et al. 2017

Med-Science

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In this study mid-and long-term outcomes of the cases with trigger finger we treated using Admix NoKorTM have been presented. Percutaneous release procedures were applied for 24 fingers of 22 (19 female, 3 male patients; mean age, 57; range, 39-72) patients between May 2009 and May 2011. Preoperatively US was performed so as to confirm the presence of trigger finger. Diameters of the tendons of the affected and intact hands measured using US, were compared so as to be able to demonstrate thickening of the tendon of the trigger finger. The patients were monitored for an average period of 25.2 (range, 14-36) months. During surgery, clinically loss of the catching sensation was observed. In two patients percutaneous trigger finger release failed, so we have to proceed with open surgery. During open surgery, we observed longitudinal wounds on the tendon. One patient developed unilateral radial digital nerve damage. Percutaneous release of the trigger finger using Admix NoKorTM 16-G gauge needle can be preferred in the treatment of trigger finger. Trigger finger of the first digit requires more attentive approach and one should be aware of the complications. If required open surgery can be preferred.

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Section: Discussionmentioning

confidence: 98%

Percutaneous surgery using Admix NoKorTM Non-Coring 16 G needle in cases with trigger finger

Kurt¹,

Kalender²,

Sevimli³

et al. 2017

Med-Science

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“…Further investigation is required as there were no cadaveric hands with trigger fingers available during this study. Flexor tendon injury is common in percutaneous release using the needle technique, 6,12,16,17 but Pope and Wolfe claimed it is not a sufficient complication. 18 To reduce the risk of flexor tendon injury, it is necessary to locate the needle tip superficially to the tendon, as described in this study.…”

Section: Discussionmentioning

confidence: 99%

“…If there is no paradoxical movement of the needle, it is safe to push the needle parallel to the A1 pulley, but not deep down. In concern about thumb nerve injury, 7,[16][17][18] we preciously used marked guidelines, the needle was inserted at the midline point of the flexor tendon, and approximation to the radial side was avoided. 17,19,20 In this study, no digital nerves were injured.…”

Section: Discussionmentioning

confidence: 99%

Identification of the location of the A1 pulley combining palpation technique with palm landmarks and percutaneous release of A1 pulley with a 19-gauge needle: A cadaveric study

Grinčuk

Baužys

Porvaneckas

et al. 2017

J Orthop Surg (Hong Kong)

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The aims of this study were to identify the location of the A1 pulley combining palpation technique with superficial palm landmarks and to determine the efficacy and safety of A1 pulley percutaneous release with a 19-gauge needle. Fourteen fresh frozen cadaveric specimens were used: 56 fingers and 14 thumbs. The location of the A1 pulley was based on anatomical landmarks and was identified in all digits. Complete release of the A1 pulley occurred in 60 of the 70 digits (85.7%). The length of the A1 pulley in thumbs was 5.7 mm and in other fingers 4.5 mm. There were no signs of neurovascular bundle injuries. The mean distance between needle pathway and neurovascular bundle was 4.3 mm in the thumbs and 6.5 mm in the other fingers. There were no total flexor tendon injuries. The location of the A1 pulley can be predicted with success. Percutaneous release of the A1 pulley with a 19-gauge needle shows acceptable results in both safety and efficacy.

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“…The disadvantages are that the surgical area is small and the digital blood vessels, nerves and flexor tendons are in close proximity. For example, in cadaver studies small longitudinal tears were determined in the flexor tendons with the percutaneous method (Bain et al, 1995). In this respect, the risk of damage to blood vessels, nerves and tendons is greater than in the open technique.…”

Section: Discussionmentioning

confidence: 99%

“…Cebesoy et al, (2007) reported that after starting with the percutaneous method, after four weeks an open approach was applied to 4 of 25 fingers due to failure. In some studies, due to the thumb and first finger nerve tissue proximity, percutaneous loosening is recommended in the treatment of trigger finger (Bain et al, 1995;Wolfe, 2005). Nonetheless, the incision used in open surgery is 2 cm in length at the most.…”

Section: Discussionmentioning

confidence: 99%