title: Ultrasound-guided percutaneous release of the annular pulley in trigger digit.
abstract: The purpose of this study was to describe and evaluate a new technique for ultrasound-guided percutaneous release of the annular pulley in trigger digit using a modified hypodermic needle. A total of 35 ultrasound-guided percutaneous releases were performed on 25 patients diagnosed and referred by hand surgeons in our institution over 16 months from October 2006. Inclusion criteria were as follows: adulthood, triggering present for at least 4 months, failure to respond to conservative management or steroid injections, no previous history of pulley release in the affected digit. Under ultrasound guidance, the affected pulley was released using a standard 19-gauge hypodermic needle bent at two points as the cutting device. Follow-up took place at 12 weeks and 6 months with improvement in triggering and clinically graded pain. At follow-up, no complications had occurred and all patients demonstrated improvement in their triggering, with complete resolution in 32 digits (91%), good improvement in 2 digits (6%) and some improvement in 1 digit (3%). This new technique uses a widely available and safe cutting device and is safe and can be used to provide definitive management for trigger finger, allowing the procedure to be performed in a variety of clinical settings.
authors.affiliation: Department of Radiology, Chelsea & Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK. grajeswaran@hotmail.com
authors.forename: Gajan
authors.initials: G
authors.lastname: Rajeswaran
authors.forename: Justin C
authors.initials: JC
authors.lastname: Lee
authors.forename: Rupert
authors.initials: R
authors.lastname: Eckersley
authors.forename: Effie
authors.initials: E
authors.lastname: Katsarma
authors.forename: Jeremiah C
authors.initials: JC
authors.lastname: Healy
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013710:Tendons / Q000601:surgery*; D016896:Treatment Outcome; D052582:Trigger Finger Disorder / Q000000981:diagnostic imaging* / Q000601:surgery*; D018084:Ultrasonography, Interventional / Q000379:methods*