Percutaneous Trigger Finger Release:
Posted by Dolf Ichtertz on Fri, Aug 01, 2008 @ 06:00 AM
Percutaneous release of the A-1 pulley of the finger or thumb has been available for over ten years to a limited degree. Only a few of us across the United States have been offering this excellent procedure. I personally have been offering it for eleven years. As long as a person's finger or thumb is actively triggering at the time of offering the procedure, there is about a 99% success rate with minimal discomfort and immediate return to activities.
Surgeons from China in the Journal of Hand Surgery, Vol. 31A, No 8, October 2006, pg. 1288, reported their results on revision percutaneous A-1 pulley release in patients in whom there was some residual snapping or locking symptoms. 90% were completely free of triggering at follow-up. They concluded that percutaneous A-1 pulley release is an effective, safe, and convenient technique for primary trigger finger and as a secondary procedure for patients who have residual triggering after the initial attempt.
My experience parallels theirs. It is pretty rare to have to convert a percutaneous release into an open release, though I have had to on several occasions over the years. Anyone undergoing open trigger release at this point in time who has not been first offered percutaneous release is making a mistake. Percutaneous release is so effective and causes such minimal discomfort that it is essentially setting the standard of care. The cost is markedly reduced as is the inconvenience. There is still some soreness for up to three months but it is much less, and there is no wound to manage. Further information regarding this is available in the trigger finger section of this website.