Ultrasonography (USG)-guided corticosteroid injection with needle release of the A1 pulley: serial case report

Abstract

Background: Trigger finger is associated with limited flexion and extension of the finger due to inflammation in the flexor tendon pulley and leads to a loss of functional capacity in the hands. There is a need for safe, fast management and a low risk of recurrence in managing this disease. This study aims to evaluate the clinical effectiveness of the USG-guided corticosteroid injection with needle release of the A1 pulley in treating the trigger finger, particularly in pain degree, joint function, and adverse effects. The parameters were evaluated, including the NRS, Quinnell grading system, and inflammation or infection signs from the physical examination. Case Presentation: There were seven trigger fingers in five patients with various Quinnell grades ranging from 2 to 3. They received a single treatment of USG-guided corticosteroid injection with needle release of the A1 pulley. Follow-up was carried out immediately after the procedure (day 0), 1 day, and 30 days after. Improvement was seen in all fingers immediately and one day after the procedure. After 30 days, all patients no longer experienced pain, snapping, or locking sensations. No adverse events were observed during the follow-up period. Conclusion: USG-guided corticosteroid injection with needle release of the A1 pulley in treating trigger fingers is safe and has a good effect on reducing pain and improving joint finger function.