PM R. 2021 Jul 2. doi: 10.1002/pmrj.12665. Online ahead of print.
ABSTRACT
INTRODUCTION: Open surgical trigger finger release has limited success with complications; however, percutaneous techniques have a successful alternative. There is limited understanding of the success of percutaneous trigger finger release.
OBJECTIVE: To prospectively evaluate the functional outcomes of patients with Green classification Grade 2 to 4 trigger finger treated with an ultrasound-guided micro-invasive trigger finger release using a special 18-gauge needle with a blade at the tip.
DESIGN: prospective, case-series study SETTING: This study took place at an academic institution by one sports medicine physician (REC) with subspecialty training and certification in musculoskeletal ultrasound.
PATIENTS: Sixty patients (79 cases) met criteria and agreed to participate in this study; 19 patients had multiple fingers treated. Average patient age was 62.8 years (SD10.2). Average trigger finger severity diagnosis was Grade 3.
INTERVENTIONS: Patients were treated with an ultrasound-guided micro-invasive trigger finger release using a special 18-gauge needle with a blade at the tip.
MAIN OUTCOME MEASUREMENTS: QuickDASH, NRS, and Nirschl scores were captured pre-procedure, at various time points, and at final follow-up. Changes between pre-procedure and final follow-up were analyzed by paired t-test (p<0.05). Differences were also analyzed between finger, grade level, and sex by repeated measures ANOVA’s (p<0.05).
RESULTS: No adverse events were documented peri-operatively or post-operatively. Average follow-up time was 18.4 months (SD 4.6). At final follow-up, 100% of patients reported no recurrence of catching/locking, 97% had complete resolution of symptoms and significant improvement in QuickDASH scores, and 99% required no further treatment. All measurements showed a decrease in pain and symptoms over time. The improvements in QuickDASH score, NRS and Nirschl scale, and the resolution of mechanical symptoms were all statistically significant.
CONCLUSION: Ultrasound-guided release using the 18-gauge needle with a blade provides significant functional improvement and full resolution of mechanical symptoms with minimal adverse events. This article is protected by copyright. All rights reserved.
PMID:34213082 | DOI:10.1002/pmrj.12665
