Ultrasound-assisted percutaneous trigger finger release: Is it safe?

Karina L. Paulius, Pirko Maguina

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

Trigger fingers can be treated by open or percutaneous division of the A1 pulley. The open approach allows for visualization of the pulley, the tendon, and the adjacent neurovascular bundles. The percutaneous trigger finger release (PTFR) lacks an incision and is thought to lead to a quicker recovery, but the safety and efficacy of this blind procedure are often questioned. Ultrasound imaging has recently been introduced as an adjunct for guiding the needle during percutaneous trigger finger release. This study was designed to evaluate the safety and efficacy of needle trigger finger release with added ultrasound imaging. Eighteen fresh cadaver A1 pulleys were divided percutaneously and then evaluated by converting to an open technique and examining the pulleys, the tendons, and the neurovascular bundles. This study's ultrasound images demonstrated repeated puncture of the tendon sheath and of the neurovascular bundle during PTFR. The subsequent dissection revealed three out of 18 tendons with visible lacerations and 15 out of 18 A1 pulleys with incomplete division. We concluded that ultrasound-guided PTFR can be complicated by flexor tendon lacerations, potential injury to neurovascular bundles, and incomplete division of the A1 pulleys. While the clinical significance of these findings is unclear to us, it does raise questions regarding the safety and efficacy of percutaneous trigger finger release, even when adding ultrasound guidance.

Original languageEnglish (US)
Pages (from-to)35-37
Number of pages3
JournalHand
Volume4
Issue number1
DOIs
StatePublished - 2009
Externally publishedYes

Keywords

  • Percutaneous release
  • Trigger finger
  • Ultrasound

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

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