Percutaneous ultrasound-guided A1 pulley release utilizing a modified 20-gauge spinal needle.

BACKGROUND

Trigger finger is a common cause of hand pain. Though multiple techniques for percutaneous A1 pulley release have been described in the literature, there is a continued need for safe and effective techniques using inexpensive, familiar, and commonly found instruments. This study evaluated outcomes of percutaneous A1 pulley release performed using a novel technique with a modified 20-gauge spinal needle and ultrasound guidance, with follow-up outcomes at least 6 months after the procedure.

OBJECTIVE

To evaluate the efficacy and safety of a novel percutaneous A1-pulley release technique in individuals with trigger finger.

DESIGN

Retrospective observational study.

SETTING

Private practice outpatient orthopedics clinic.

PARTICIPANTS

Forty digits from 30 unique patients with trigger finger who underwent percutaneous A1 pulley release.

INTERVENTIONS: Percutaneous ultrasound-guided A1 pulley release performed with a modified 20-gauge spinal needle.

MAIN OUTCOME MEASURES: The primary outcome measure was cessation of triggering. Secondary measures examined intraoperative and postoperative pain, postprocedural duration of activity limiting pain, and time to perform the procedure.

RESULTS

Immediate cessation of triggering was achieved in all 40 digits following the procedure, with no recurrence reported at any time at an average follow-up of 11 months (range 6-32). Patients reported returning to normal activity in 2.75 days. Only one minor complication was reported, tenosynovitis, which resolved with a corticosteroid injection.

CONCLUSIONS

Percutaneous, ultrasound-guided A1 pulley release performed with a modified 20-gauge spinal needle can be safely performed with good outcomes and a rapid return to normal activity.