Clinical experience of the percutaneous release for trigger fingers

Ryu, Han Koo; Lee, Sang Kon; Min, Byung Woo; Ban, Jong Suk; Lee, Ji Hyang; Kim, Eun Joo

Abstract

BACKGROUND
Conservative management for the trigger fingers includes splinting, steroid injection and other adjuvant methods. If conservative treatment fails, a surgical release of the A1 pulley is offered. Although the success rate of the surgical intervention is high, the complications, for example, a digital nerve injury, bowstringing, infection and continued triggering, have been reported. Percutaneous release with an 18 guage needle has been reported as a safe and effective procedure for the trigger fingers. This study evaluates the safety and efficacy of the percutaneous release.
METHODS
33 patients received the percutaneous release of the A1 pulley with an 18 guage needle and steroid injection (Group A) and 36 patients did the only administration of steroid as a control group (Group B). Patients were examined with a clinical staging for the Watanabe stage (W stage) and 0-10 points verbal numerical rating scale (VNRS) score at 1 week, 3 months, 1 year after the initial treatment.
RESULTS
After 1 year of the follow-up, 93.5% in the group A and 57.6% in the group B had complete release of the trigger fingers in the W stage. VNRS after the initial treatment demonstrated that the decrement of the pain score was more significant in the group A.
CONCLUSIONS
We need to consider the percutaneous release with steroid injection at an early stage of the trigger fingers because of the more effective resolution of the symptoms and the better long-term prognosis than a steroid injection alone.