Work

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

Year: 2024

Type: article

Abstract: 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.

Source: PM&R

DOI: 10.1002/pmrj.13276

Authors: Mark Sederberg, Ragav Sharma, Daniel M. Cushman, Jonathan T. Finnoff

Institutions: University of Utah, Medical College of Wisconsin, United States Olympic & Paralympic Committee, University of Colorado Anschutz, University of Colorado Denver

Language: English

Topic: Orthopedic Surgery and Rehabilitation

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,300