Open Versus Percutaneous Release of the A1-Pulley for Stenosing Tendovaginitis

2008 ◽  
Vol 12 (3) ◽  
pp. 183-187 ◽  
Author(s):  
Ulf Dierks ◽  
Reimer Hoffmann ◽  
Marcel F. Meek
Keyword(s):  
Percutaneous Release ◽  
Open Versus ◽  
Stenosing Tendovaginitis ◽  
A1 Pulley

Sonographically Assisted Percutaneous Release of the A1 Pulley: A New Surgical Technique for Treating Trigger Digit

2006 ◽  
Vol 31 (2) ◽  
pp. 191-199 ◽  
Author(s):  
I. M. JOU ◽  
T. C. CHERN
Keyword(s):  
Cadaver Study ◽  
Safe Zone ◽  
Prospective Clinical Study ◽  
Percutaneous Technique ◽  
Direct Visualization ◽  
Percutaneous Release ◽  
Neurovascular Structures ◽  
A1 Pulley ◽  
New Surgical Technique

This study introduces a sonographically assisted percutaneous technique for releasing trigger digits which provides direct visualization of the release and avoids the risks of incomplete release and injury to adjacent neurovascular structures associated with other percutaneous release techniques. The “safe zone” and an estimate of the size of the A1 pulley were determined in a separate cadaver study. We then used these landmarks in a prospective clinical study of 107 digits in 83 consecutive patients treated by this technique. During the follow-ups of between 9 and 15 months, we evaluated 104 digits in 80 patients. Pain was absent in 101 digits (97%) and considerably improved in the other three (3%). All mechanical problems had been resolved and none recurred during follow-up. This technique allows the surgeon to see and monitor, precisely, the percutaneous division of the A1 pulley without open surgery and, therefore, to avoid the inherent risks of percutaneous and open surgical release.

A1 Pulley Release of Locked Trigger Digit by Percutaneous Technique

2004 ◽  
Vol 29 (5) ◽  
pp. 502-505 ◽  
Author(s):  
M. J. PARK ◽  
I. OH ◽  
K. I. HA
Keyword(s):  
Physical Therapy ◽  
Surgical Procedure ◽  
Percutaneous Technique ◽  
Office Setting ◽  
Neurovascular Injury ◽  
Percutaneous Release ◽  
Open Surgical Procedure ◽  
A1 Pulley

We performed 118 percutaneous releases of the locked trigger digits in an office setting using a specially designed knife. Thirty-five digits were locked in flexion, 79 digits in extension and the remaining four were fixed in a semiflexed position. Successful percutaneous release was achieved for 107 digits (91%), with the remaining 11 digits requiring an open surgical procedure. Although there were no persistent triggering in 98 digits with a follow-up of at least 6 months, painful stiffness at the interphalangeal joints remained in ten digits despite of physical therapy. No neurovascular injury occurred. We suggest that a locked trigger digit can be successfully released with the percutaneous technique.

scholarly journals Results of percutaneous release of stenosing tenosynovitis (trigger finger) using hypodermic needle

2019 ◽  
Vol 5 (4) ◽  
pp. 578
Author(s):  
Shiv Kumar ◽  
Khalid Muzzafar ◽  
Irfan Tasaduq ◽  
Arpan Bijyal
Keyword(s):  
Hand Function ◽  
Trigger Finger ◽  
Hypodermic Needle ◽  
Common Condition ◽  
Open Release ◽  
Percutaneous Release ◽  
Stenosing Tenosynovitis ◽  
Level Hospital ◽  
A1 Pulley

<p class="abstract"><strong>Background:</strong> Stenosing tenosynovitis or trigger finger is a common condition affecting finger function, which can lead to disability in hand function. Treatment in form of conservative can be helpful in early stages, however later stages and chronic triggering needs release of A1 pulley either by open or percutaneous methods. The aim of this study was to find the results of percutaneous release of trigger finger with 18 guage needle.</p><p class="abstract"><strong>Methods:</strong> 43 digits in 36 patients were enrolled for this prospective study in a district level hospital over a 2 year period. Release was done under local anaesthesia using 18 guage needle percutaneously. Follow up was done upto 6 months. Final scoring was done at 6 months using Quinell’s criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> We had 81.39% (35 out of 43) excellent to good results. 19.61% (8) needed open release. We had no neurovascular injury or infection in our series.</p><p class="abstract"><strong>Conclusions:</strong> Percutaneous release by 18 guage needle is safe and effective treatment for trigger finger without much complication.</p>

Percutaneous A1 pulley release vs steroid injection for trigger digit: the results of a prospective, randomized trial

2010 ◽  
Vol 36 (1) ◽  
pp. 53-56 ◽  
Author(s):  
A. Zyluk ◽  
G. Jagielski
Keyword(s):  
Primary Outcome ◽  
Outcome Measure ◽  
Steroid Injection ◽  
Primary Outcome Measure ◽  
Term Therapy ◽  
Medium Term ◽  
Range Of Movement ◽  
Percutaneous Release ◽  
Release Group ◽  
A1 Pulley

This study compared the results of percutaneous A1 pulley release and steroid injection in 105 trigger digits in 95 patients. The patients were randomly assigned to either surgery (43 patients, 46 digits) or steroid injection (52 patients, 59 digits). The results were assessed at 1 and 6 months and the measurements included rate of recurrence (primary outcome measure), pain on movement, active range of movement of the affected digit and grip strength. No recurrences were seen at 1 month. At the 1 month assessment, patients after steroid injection achieved greater active range of movement of the fingers (270° vs 264°) and stronger grip (99% vs 85%) than those treated by percutaneous release. At the 6 month assessment six recurrences (11%) occurred in the steroid injection group and none in the percutaneous release group ( P = 0.005). Patients after percutaneous release had less pain on movement of the involved digit (VAS 0.4 vs 1.3), but still had lower AROM of the fingers (265° vs 270° after steroid injection). We conclude that percutaneous A1 pulley release is more effective medium-term therapy for trigger digit than steroid injection, because of lower risk of recurrence.

A Systematic Review of Tennis Elbow Surgery: Open Versus Arthroscopic Versus Percutaneous Release of the Common Extensor Origin

2017 ◽  
Vol 33 (6) ◽  
pp. 1260-1268.e2 ◽  
Author(s):  
Todd P. Pierce ◽  
Kimona Issa ◽  
Benjamin T. Gilbert ◽  
Brian Hanly ◽  
Anthony Festa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Tennis Elbow ◽  
Percutaneous Release ◽  
Elbow Surgery ◽  
The Common ◽  
Open Versus

PERCUTANEOUS A1 PULLEY RELEASE A CLINICAL STUDY

Hand Surgery ◽  
1999 ◽  
Vol 04 (01) ◽  
pp. 45-50 ◽  
Author(s):  
G. I. Bain ◽  
N. A. Wallwork
Keyword(s):  
Cost Savings ◽  
Outpatient Setting ◽  
Percutaneous Technique ◽  
Intravenous Catheter ◽  
Effective Technique ◽  
Percutaneous Release ◽  
Flexor Tendon Injuries ◽  
Palpable Nodule ◽  
Time Of Presentation ◽  
A1 Pulley

Percutaneous A1 pulley release is being increasingly used as an alternative to open surgical release and injection of local steroids for the treatment of the trigger digit. In 31 cases (26 patients), a percutaneous release was performed with a 14-gauge intravenous catheter needle under local anaesthesia in the outpatient setting. We report a 97% successful release and only one case of incomplete release. There were no digital nerve injuries, flexor tendon injuries, bowstringing or infections. By two months, all the patients had no pain at the operative site, and their preoperative range of motion had returned or improved. The percutaneous release is a safe and effective technique which provides significant cost savings. We recommend the percutaneous technique for typical cases of trigger finger with a palpable nodule and reproducible mechanical triggering. We recommend a steroid injection for patients with tenosynovitis and those who do not have reproducible triggering at the time of presentation. The open technique is reserved for complicated cases such as florid tenosynovitis, locked digit, failed percutaneous release or those involving the thumb.

Sign in / Sign up

Export Citation Format

Share Document