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Comment
. 2024 Jul;19(5):823-830.
doi: 10.1177/15589447221150512. Epub 2023 Feb 1.

Single-Portal Antegrade Endoscopic Trigger Finger Release: Cadaveric and Clinical Outcomes

Ather Mirza  1   2   3 , Justin Mirza  1   2   3   4 , Luke Zappia  2   4 , Terence L Thomas  2   5 , Jagger Corabi  2 , Robert Talay  3
Affiliations
Comment

Single-Portal Antegrade Endoscopic Trigger Finger Release: Cadaveric and Clinical Outcomes

Ather Mirza et al. Hand (N Y). 2024 Jul.

Abstract

Background: This study aimed to examine the relationship between anatomical surface landmarks in fresh frozen cadavers as related to in vivo endoscopic trigger finger release (ETFR) and present clinical outcomes after a single-portal antegrade ETFR technique.

Methods: Endoscopic trigger finger release was performed on 40 cadaveric digits. Each digit was dissected and the following measurements were recorded: distance from palmar digital crease and A1 pulley, length of the A1 pulley, percentage of A1 pulley released, and injury to vulnerable anatomy. A retrospective chart review was performed on 48 patients (62 digits) treated with ETFR. Outcome measures included grip and pinch strength, range of motion, Disability of Arm, Shoulder, and Hand (DASH) questionnaires, and Visual Analog Scale (VAS) pain scores.

Results: Release of the A1 pulley was achieved in 33 of the 40 cadaveric digits (83%) with an A2 pulley laceration rate of 25%. No flexor tendon or neurovascular injuries occurred. Gross grasp, lateral pinch, 3-jaw chuck, and precision pinch strength had 85%, 90%, 82%, and 90% recovery, respectively. At the final follow-up, average metacarpophalangeal joint, proximal interphalangeal joint, and distal interphalangeal joint range of motion were within the normal limits. Mean VAS scores decreased from 5.7 preoperatively to 1.0 postoperatively and mean DASH score at the final follow-up was 4.8.

Conclusions: With the use of anatomical surface landmarks, ETFR may be performed in an efficient and reproducible manner. Patients treated with ETFR had low complication rates, good functional recovery, and improved pain at short-term follow-up. Further study of long-term outcomes and cost-effectiveness of ETFR is warranted.

Keywords: anatomy; diagnosis; endoscopic device; hand; outcomes; research and health outcomes; specialty; stenosing tenosynovitis; surgery; surgical techniques; tendon; treatment; trigger finger.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: A.M. receives IP royalties, financial or material support, and stock or stock options from A.M. Surgical, Inc; J.M. receives other financial or material support from A.M. Surgical, Inc; L.Z. and T.T. are former employees of A.M. Surgical, Inc; J.C. is a current employee of A.M. Surgical, Inc. R.T. reports no conflict of interest to disclose.

Figures

Figure 1.
Figure 1.
Anatomical indication of hand markings used for A1 pulley approximation.
Figure 2.
Figure 2.
Endoscopic visualization and division of the A1 pulley.
See this image and copyright information in PMC

Comment on

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