Percutaneous release of trigger digits

Ha, Kwon Ick; Park, Myeongjin; Ha, Chul‐Won

doi:10.1302/0301-620x.83b1.11247

Cited by 69 publications

(50 citation statements)

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“…The "blind" percutaneous technique uses surface anatomical landmarks [12][13][14][15][16][17][18][19][20][21][22]. Although it has been shown to be safe, it is complicated by incomplete release or the need to convert to an open release, which has been reported in up to 11% of cases [13,16,23].…”

Section: Discussionmentioning

confidence: 99%

“…Here, its tip is seen transecting the A1 pulley. Note how the operator can ensure that it remains dead centre over the flexor tendon under sonographic guidance during the procedure, particularly the digital nerves which have been shown to have a variable course in cadaveric studies [12][13][14][15][16][17][18][19][20][21][22]. Several studies suggest the variation in digital nerve position in the thumb, index and little finger puts non-image-guided percutaneous release at risk of complications [6,8,12,16,20,[24][25][26].…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound-guided percutaneous release of the annular pulley in trigger digit

et al. 2009

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The purpose of this study was to describe and evaluate a new technique for ultrasound-guided percutaneous release of the annular pulley in trigger digit using a modified hypodermic needle. A total of 35 ultrasound-guided percutaneous releases were performed on 25 patients diagnosed and referred by hand surgeons in our institution over 16 months from October 2006. Inclusion criteria were as follows: adulthood, triggering present for at least 4 months, failure to respond to conservative management or steroid injections, no previous history of pulley release in the affected digit. Under ultrasound guidance, the affected pulley was released using a standard 19-gauge hypodermic needle bent at two points as the cutting device. Follow-up took place at 12 weeks and 6 months with improvement in triggering and clinically graded pain. At follow-up, no complications had occurred and all patients demonstrated improvement in their triggering, with complete resolution in 32 digits (91%), good improvement in 2 digits (6%) and some improvement in 1 digit (3%). This new technique uses a widely available and safe cutting device and is safe and can be used to provide definitive management for trigger finger, allowing the procedure to be performed in a variety of clinical settings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided percutaneous release of the annular pulley in trigger digit

et al. 2009

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“…Recently published studies show promising results using different materials: special knifes, scalpels, needles, and ultrasound guide. 4,5,[8][9][10] Eastwood et al successfully achieved percutaneous release in 33 of 35 fingers (94%) with a 21-gauge hypodermic needle. 11 Hoang et al reported a success rate of 74% on cadavers with restored perfusion using an 18-gauge needle.…”

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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“…9 For percutaneous release of trigger thumb, the pulley location needs to be carefully delineated by the positioning of the thumb in abduction, slightly flexing the wrist and performing supination of the forearm. 2,14,15 The knife is inserted 1cm distal to the metacarpophalangeal crease, in the center of the thumb under local anesthesia. The proximal edge of the pulley is identified at the level of the metacarpophalangeal crease.…”

Section: Surgical Techniquementioning

confidence: 99%

“…Conservative treatment involves a high failure rate, requiring repetitive injections. 1,2 When conservative treatment fails, open release of the A1 2-4 pulley is recommended. Lorthioir 5 described a percutaneous release technique using a thin tenotome for the first time.…”

Section: Introductionmentioning

confidence: 99%

Liberação percutânea do dedo em gatilho com micro bisturi oftalmológico vitreorretiniano de lâmina 19

Uruç¹,

Cingü²,

Sayıt

et al. 2011

Acta ortop. bras.

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OBJETIVO: Desenvolver uma nova técnica de liberação percutânea do dedo em gatilho, usando microbisturi oftalmológico vitreorretiniano (MVR) de lâmina 19. MÉTODO: O tratamento conservador do dedo em gatilho inclui, com frequência, injeção local de esteroide. Esse método apresenta alta taxa de falha, sendo necessárias injeções repetitivas. Quando o tratamento conservador falha, recomenda-se a liberação a céu aberto da polia A1. Foram relatados vários métodos que empregam diversos instrumentos. Usamos um microbisturi oftalmológico vitreorretiniano (MVR, de microvitreoretinal blade) de lâmina 19 na liberação percutânea do dedo em gatilho. RESULTADOS: Liberamos 50 dedos em gatilho por via percutânea com essa lâmina. CONCLUSÃO: Foram obtidos resultados satisfatórios em 45 deles (90%). Nivel de Evidência VI, série de casos.

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Percutaneous release of trigger digits

Cited by 69 publications

References 0 publications

Ultrasound-guided percutaneous release of the annular pulley in trigger digit

Ultrasound-guided percutaneous release of the annular pulley in trigger digit

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

Liberação percutânea do dedo em gatilho com micro bisturi oftalmológico vitreorretiniano de lâmina 19

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