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

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J Hand Surg [Am]. 2006 Oct;31(8):1288-91.

Revision of incompletely released trigger fingers by percutaneous

release: results and complications.

Fu YC, Huang PJ, Tien YC, Lu YM, Fu HH, Lin GT.

Department of Orthopaedics, Chung-Ho Memorial Kaohsiung Medical

University Hospital, Kaohsiung Medical University.

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.

PMID: 17027788

http://www.ncbi.nlm.nih.gov/pubmed/17027788

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