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US-guided Percutaneous Release of the Trigger Finger by Using a 21-gauge Needle: A Prospective Study of 60 Cases.

Lapègue, Franck and André, Aymeric and Meyrignac, Olivier and Pasquier-Bernachot, Etienne and Dupré, Pierre and Brun, Caroline and Bakouche, Sarah and Chiavassa-Gandois, Hélène and Sans, Nicolas and Faruch, Marie US-guided Percutaneous Release of the Trigger Finger by Using a 21-gauge Needle: A Prospective Study of 60 Cases. (2016) Radiology, 280 (2). 493-499. ISSN 0033-8419

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Official URL: https://doi.org/10.1148/radiol.2016151886

Abstract

Purpose: To evaluate the efficacy of ultrasonographically (US)-guided percutaneous treatment of the trigger finger by releasing the A1 pulley with a 21-gauge needle. Materials and Methods : This two-part study was approved by the ethics committee, and written consent was obtained from all patients. The first part consisted of 10 procedures on cadaver digits followed by dissection to analyze the effectiveness of the A1 pulley release and detect any collateral damage to the A2 pulley, interdigital nerves, or underlying flexor tendons. The second part was performed during an 18-month period starting in March 2013. It was a prospective clinical study of 60 procedures performed in 48 patients. Outcomes were evaluated through a clinical examination at day 0 and during a 6-month follow-up visit, where the trigger digit was evaluated clinically and the Quick Disabilities of the Arm, Shoulder and Hand outcome measure, or QuickDASH, and patient satisfaction questionnaires were administered. Results : No complications were found during the cadaver study. However, the release was considered "partial" in all fingers. In the clinical study, the trigger finger was completely resolved in 81.7% (49 of 60) of cases immediately after the procedure. Moderate trigger finger persisted in 10 cases, and one thumb pulley could not be released. A US-guided corticosteroid injection was subsequently performed in these 11 cases. At 6-month follow-up, only two cases still had moderate trigger finger and there were no late complications. The mean QuickDASH questionnaire score was 4; all patients said they were satisfied. Conclusion : US-guided treatment of the trigger finger by using a 21-gauge needle is feasible in current practice, with minimal complications.

Item Type:Article
Additional Information:Thanks to RSNA editor. The definitive version is available at http://pubs.rsna.org/ The original PDF of the article can be found at http://pubs.rsna.org/doi/10.1148/radiol.2016151886
Audience (journal):International peer-reviewed journal
Uncontrolled Keywords:
Institution:Other partners > Centre d'imagerie du Languedoc - CIL (FRANCE)
Other partners > Centre Hospitalier Universitaire de Toulouse - CHU Toulouse (FRANCE)
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Deposited By: Pascal SWIDER
Deposited On:16 Nov 2017 09:56

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