Revision of incompletely released trigger fingers by percutaneous release: results and complications.

PURPOSE: Percutaneous trigger digit release has been reported as a safe, effective, and quick procedure, but most surgeons convert to an open method for residual triggering after percutaneous release. This study evaluates the safety and efficacy of repeated percutaneous release for patients who had residual triggering after the initial percutaneous release.

METHODS

Between January 2000 and December 2002, 31 patients with a mean age of 55 years had a repeat percutaneous release to treat residual snapping or locking symptoms. Surgery was performed in the physician's office using the tip of a 19-gauge needle mounted on a 2-mL syringe. Patients received regular postoperative follow-up examinations at 1, 6, and 12 weeks after surgery, and at the last visit, they completed a questionnaire regarding the duration of pain or swelling and when were they able to return to normal work.

RESULTS

Twenty-eight digits (90%) were completely free of triggering. Three digits (10%) during follow-up evaluation had residual snapping. Of these, 1 patient had repeated percutaneous release, which achieved an excellent outcome; 1 patient favored an open-release technique, and 1 patient refused further treatment. No complications were identified at the final follow-up examinations. Almost all patients returned to normal work within 3 days.

CONCLUSIONS

Percutaneous A1 pulley release is an effective, safe, and convenient technique for the primary trigger finger and as a secondary procedure for patients who have residual triggering after the initial surgical procedure.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.