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Clinical Trial
. 2007 Jun;31(3):345-9.
doi: 10.1007/s00264-006-0180-1. Epub 2006 Jul 18.

Percutaneous release of the trigger thumb: is it safe, cheap and effective?

Oguz Cebesoy  1 , Kamil Cagri Kose, Enver Taner Baltaci, Mustafa Isik
Affiliations
Clinical Trial

Percutaneous release of the trigger thumb: is it safe, cheap and effective?

Oguz Cebesoy et al. Int Orthop. 2007 Jun.

Erratum in

  • Int Orthop. 2007 Jun;31(3):351. Karakurum, Gunhan [removed]

Abstract
in English, French

Percutaneous release of the trigger finger and trigger thumb has recently gained popularity. The aim of this study was to determine the clinical results and safety of percutaneous release in trigger thumbs. Twenty-five thumbs of 21 patients were released percutaneously in the polyclinic under local anaesthesia. Steroid injection was performed following the release procedure using the same needle. The thumb function was evaluated by a patient questionnaire, and functional thumb scores (VAS) were calculated in the preoperative and postoperative periods. At the 1 week follow-up, four patients had signs of discomfort and triggering because of incomplete release. These patients underwent open A1 pulley release. Three superficial tendon lacerations were seen during these open procedures. There were no wound complications or signs of digital nerve or artery injury in any of the patients. The preoperative mean VAS was 26.62 (18-36). This decreased to 2.57 (0-5) at the first postoperative month (P<0.001) and to 2.19 (0-3; P<0.001) at the sixth month. When the VAS scores at the first and sixth months were compared, the difference was statistically significant. We concluded that percutaneous release of trigger thumbs is a cheap, safe and effective procedure with a low rate of complications.

La liberation per-cutanée des doigts à ressaut s’est récemment développée, mais peu au niveau du pouce à cause de son orientation. Le but de cette étude était d’apprécier la fiabilité et le résultat clinique d’une telle libération sur 25 pouces chez 21 patients opérés sous anesthésie locale. Une injection de stéroide était faite à la suite de la libération par la même aiguille. La fonction du pouce était évaluée par un questionnaire et un score fonctionnel (VAS) était calculé en période pré- et post-opératoire. Après une semaine quatres patients avaient des signes d’inconfort et de ressaut ce qui a conduit à une libération à ciel ouvert de la poulie A1. Trois lacérations superficielles de tendon étaient constatées durant ces interventions à ciel ouvert. Il n’y avait aucune complication vasculaire, nerveuse, ou cutanée. Le score pré-opératoire moyen était de 26,62 (18–36). Il diminuait à 2,57 (0–5) un mois après l’opération (P<0,001) et à 2,19 (0–3) (P<0,001) à 6 mois. Quand les scores VAS étaient comparés à 1 mois et à 6 mois de recul, la différence était statistiquement significative. Nous concluons que la libération per-cutanée des pouces à ressaut est une technique sure avec peu de complication.

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Figures

Fig. 1
Fig. 1
Insertion of the 18-G needle to release the A1 pulley
Fig. 2
Fig. 2
Administration of steroid using the same needle
Fig. 3
Fig. 3
Photography after all of the procedures were completed
Fig. 4
Fig. 4
The superficial laceration of the flexor tendon seen in one of the failed cases during open surgery
See this image and copyright information in PMC

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