Clinical Results of Trigger Finger Release with Percutaneous Needle Technique Under Local Anesthesia

Percutaneous Trigger Finger Release

Abstract

Background: Trigger Finger (or trigger thumb) is because of mechanical impingement at the level of the A1 pulley and affects 2-3% of the general population and 10% of the diabetic population. It causes progressive pain and locking of the digit which often requires surgical release when conservative treatment fails. Objective: To assess the outcomes of trigger finger release using percutaneous needle technique. Study Design: Prospective interventional study. Settings: Orthopedic Department of King Edward Medical University/ Mayo Hospital Lahore, Pakistan. Duration: Six months from July 2023 to December 2023. Methods: A total of 32 patients with 19 women and 13 men were included in the study. Biodata and basic information were recorded and disease was graded according to Green Classification. Patients were called to the operation theatre on an outdoor basis and percutaneous release of the A1 pulley was performed using an 18-gauge needle under local anesthesia after obtaining informed written consent. Immediately After the procedure, the finger was assessed functionally using Quinell’s criteria and for pain using Visual Analogue Scoring (VAS). All patients were followed for three months after the release. Results: The Technique was successful in all the 32 patients (100%). No patient was found with recurrence during the initial three months of follow-up. One-third of the patients had excellent outcomes while two-thirds had good outcomes according to Quinell’s grading system. No patient had a poor outcome. Conclusion: Percutaneous release of the trigger finger with the needling technique is an easy, time-saving, resource-saving technique and minimally invasive approach. It also reduces the risk of post-operative wound infection in the diabetic population.