Atul Panghate1, Sameer Panchal2, Akil Prabhakar3, Abhinav Jogani1. 1. Department of Orthopaedics, King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Acharya Donde Marg, Parel, Mumbai, Maharashtra, 400012, India. 2. Department of Orthopaedics, Grant Medical College, JJ Marg, Nagpada, Byculla, Mumbai, 400008, India. 3. Department of Orthopaedics, Lokmanaya Tilak Municipal General Hospital, Dr Babasaheb Ambedkar Rd, RB2 Central Railway Quarters, Sion West, Sion, Mumbai, Maharashtra, 400022, India.
Abstract
BACKGROUND: Trigger finger or stenosing tenosynovitis is a disproportion between the volume of the tendon sheath and its contents. This disproportion prevents gliding of the tendon as it moves freely through the annular pulley. The technique of percutaneous release of the annular pulley for trigger finger has been described well in the literature, which has undergone several modifications, like use of hypodermic needle, tenotome or specially designed knives. METHOD: We performed percutaneous trigger finger release using a 20-gauge hypodermic needle to know the outcome and efficacy of the technique post release. A Prospective cohort study was conducted in 80 consecutive trigger fingers of 67 patients who were treated by percutaneous release using 20-gauge hypodermic needle. Quinell's grading system was used to quantify severity of triggering and pain was assessed using visual analogue scale (VAS) before and after the procedure. Patients were evaluated based on these two parameters at timely interval and final outcome was assessed at the end of one year. RESULTS: Out of 80 digits treated, most of the subjects were in the age group 40-50 years (39.07%). Most common grade of trigger finger observed was Grade 3 (60%) followed by Grade 4 (30%) with VAS score of 8 (46%) followed by VAS score of 7 (24%) before release. At a year follow-up 95% of patients improved to grade 0 and mean VAS score was 0.44. Three patients developed scar tenderness, which gradually subsided by analgesics and physiotherapy with no other major complications. CONCLUSION: Our technique of percutaneous release of trigger digit with 20 G needle is effective and can be performed safely with ease. It is cost efficient and has a short learning curve with great acceptance being an outpatient procedure.
BACKGROUND: Trigger finger or stenosing tenosynovitis is a disproportion between the volume of the tendon sheath and its contents. This disproportion prevents gliding of the tendon as it moves freely through the annular pulley. The technique of percutaneous release of the annular pulley for trigger finger has been described well in the literature, which has undergone several modifications, like use of hypodermic needle, tenotome or specially designed knives. METHOD: We performed percutaneous trigger finger release using a 20-gauge hypodermic needle to know the outcome and efficacy of the technique post release. A Prospective cohort study was conducted in 80 consecutive trigger fingers of 67 patients who were treated by percutaneous release using 20-gauge hypodermic needle. Quinell's grading system was used to quantify severity of triggering and pain was assessed using visual analogue scale (VAS) before and after the procedure. Patients were evaluated based on these two parameters at timely interval and final outcome was assessed at the end of one year. RESULTS: Out of 80 digits treated, most of the subjects were in the age group 40-50 years (39.07%). Most common grade of trigger finger observed was Grade 3 (60%) followed by Grade 4 (30%) with VAS score of 8 (46%) followed by VAS score of 7 (24%) before release. At a year follow-up 95% of patients improved to grade 0 and mean VAS score was 0.44. Three patients developed scar tenderness, which gradually subsided by analgesics and physiotherapy with no other major complications. CONCLUSION: Our technique of percutaneous release of trigger digit with 20 G needle is effective and can be performed safely with ease. It is cost efficient and has a short learning curve with great acceptance being an outpatient procedure.
Authors: Bradon J Wilhelmi; Arian Mowlavi; Michael W Neumeister; Reuben Bueno; W P Andrew Lee Journal: Plast Reconstr Surg Date: 2003-09-15 Impact factor: 4.730