Abstract
IntroductionTrigger finger is a common cause of pain and disability of the hand. Percutaneous release results in earlier functional recovery and patient satisfaction. This is a rapid and cost-effective method which saves a surgical procedure and results in better functional outcome.Materials and MethodsThis is a prospective observational study conducted on fifty-two fingers and thumbs in 52 patients treated from 1st July 2014 till 31st December 2014, in the Orthopaedic Section, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan. All the baseline characteristics of the patients, like demographics, symptoms, Quinell's criteria and functional outcome were recorded. The patients were treated at our hospital with trigger finger, managed with percutaneous release using an 18 gauge needle and followed up for a minimum period of three months. The follow-up information included range of motion scoring, patient satisfaction and overall outcome of the procedure in terms of patient acceptance. The data was analyzed to determine the functional outcome at three months.ResultsThere was complete release of A1 pulleys in 52 out of 52 digits (100%) in the patients undergoing percutaneous release and significant patient satisfaction. No recurrence was observed.ConclusionPercutaneous release of trigger finger with needle was not only associated with excellent functional outcome and recovery in terms of patient satisfaction and range of finger motion three months post-procedure but also was found to be cost effective.
Highlights
Trigger finger is a common cause of pain and disability of the hand
The phenomenon of tendon entrapment is due to mechanical impingement of the digital flexor tendons as they pass through a narrowed A1 pulley 6 at the level of the metacarpal head
Secondary trigger finger can be seen in patients with diabetes[9], gout, renal disease, rheumatoid arthritis 10 and other rheumatic diseases and is associated with a worse prognosis after conservative or surgical management 1
Summary
Percutaneous release results in earlier functional recovery and patient satisfaction. This is a rapid and cost-effective method which saves a surgical procedure and results in better functional outcome. The patients were treated at our hospital with trigger finger, managed with percutaneous release using an 18 gauge needle and followed up for a minimum period of three months. Conclusion: Percutaneous release of trigger finger with needle was associated with excellent functional outcome and recovery in terms of patient satisfaction and range of finger motion three months post-procedure and was found to be cost effective. Trigger finger is one of the common causes of pain and disability of the hand .1,2 This condition results in painful catching 3 or popping of the involved flexor tendon 4 as the patient flexes and extends the digit. This bimodal distribution represents two different clinical groups; for age and in incidence, sex distribution, digit affected, treatment, and outcome 1
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