Ultrasound-guided acupotomy release of A1 pulley in the treatment of trigger thumb: A case report.

RATIONALE: Trigger thumb, characterized by A1 pulley thickening secondary to tendon sheath stenosis, represents a common clinical entity. While multiple therapeutic options exist, ultrasound-guided acupotomy has gained significant clinical adoption in China yet remains inadequately documented in the scientific literature. This study reports a case of trigger thumb managed with ultrasound-guided acupotomy.

PATIENT CONCERNS: A 49-year-old female presented with a 3-month history of audible clicking and discomfort during flexion-extension of the left thumb. Physical examination revealed pain, swelling, and persistent tenderness localized to the base and palmar aspect of the affected thumb, exacerbated by routine manual activities. No antecedent trauma was reported. A significant reduction in the left thumb's range of motion was objectively documented.

DIAGNOSES: The patient was diagnosed with trigger thumb (stenosing tenosynovitis) based on characteristic clinical manifestations and physical findings.

INTERVENTIONS: Ultrasound-guided acupotomy was performed to release the stenosed A1 pulley of the left thumb.

OUTCOMES: Postintervention outcomes included immediate pain resolution, complete cessation of clicking sounds, significant restoration of thumb range of motion, and functional recovery of the affected digit.

LESSONS: This case demonstrates that ultrasound-guided acupotomy achieves rapid and substantial therapeutic efficacy in trigger thumb management. The technique preserves tendon integrity while minimizing procedural risks, establishing its potential as a valuable clinical intervention warranting broader investigation and application.