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Percutaneous A1 Pulley Release by the Tip of a 20-G Hypodermic Needle Before Open Surgical Procedure in Trigger Finger Management

Mishra, Sudhir R. MBBS, DNB (PMR); Gaur, Anil K. MBBS, DNB (PMR); Choudhary, Mahesh M. MBBS, MS (Ortho); Ramesh, Jayshree MBBS, MD (PMR), DNB (PMR)

Techniques in Hand & Upper Extremity Surgery: June 2013 - Volume 17 - Issue 2 - p 112–115
doi: 10.1097/BTH.0b013e31828ef983

The objective of the study was to assess the safety, the efficacy, and the result of percutaneous A1 pulley release, using the tip of a 20-G hypodermic needle; the study included 17 patients with 27 trigger digits (18 grade IIIA, 8 grade IIIB, and 1 grade IV). All the patients were assessed by the total range of motion of the affected digit, the visual analog scale score, and the Disability of Arm Shoulder Hand score, before and after the procedure and during the follow-up at 2, 6, 12, and 24 weeks, and then every 3 months, and the improvement was assessed by one sample t test. Sixteen patients with 26 trigger digits (95.4%) showed complete relief of symptoms with no recurrence and a statistically significant improvement in the range of motion, the visual analog scale score, and the Disability of Arm Shoulder Hand score with a P-value <0.0001, which concludes that the procedure is safe, effective, and highly successful with good results and lower complications, comparable to those reported in papers on open release for grade III and IV trigger fingers.

Department of Physical Medicine and Rehabilitation, All India Institute of Physical Medicine and Rehabilitation, Mumbai, Maharashtra, India

Source of Funding: Supported by the Ministry of Health and Family Welfare, Government of India.

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Conflicts of Interest: The authors report no conflicts of interest.

Address correspondence and reprints requests to Sudhir R. Mishra, MBBS, DNB (PMR), Flight View Chs B-102 Radhragram, Vakola Santacruz (East), Mumbai 400055, India. E-mail:

© 2013 by Lippincott Williams & Wilkins