Ultrasound-guided first annular pulley injection for trigger finger.
OBJECTIVE
The purpose of this study was to develop an ultrasound-guided first annular (A1) pulley injection technique for trigger finger with documentation of outcomes at 1 year.


METHODS
We performed a short-axis injection into a triangle bordered by the A1 pulley, the flexor digitorum superficialis and profundus tendons and volar plate, and the distal metacarpal bone with a 10-mg median dose of triamcinolone acetonide and 2% lidocaine. This was a prospective study of 50 of 52 consecutive trigger fingers from 24 patients recruited from a physical medicine and rehabilitation private practice.


RESULTS
All patients were available for follow-up, with 94% (47 of 50) of fingers having complete resolution of symptoms at 6 months, 90% (37 of 41) at 1 year, 65% (17 of 26) at 18 months, and 71% (12 of 17) at 3 years after a single injection.


CONCLUSIONS
Our ultrasound-guided A1 pulley injection technique is a highly effective and minimally invasive treatment option for trigger finger with a 90% success rate at 1 year for complete resolution of symptoms after a single injection. Assuming similar patient populations, our results were statistically significant (P < .01) compared with the 56% to 57% success rates recently reported for blind injections.
Bodor
Marko
M
Queen of the Valley Medical Center, 3421 Villa Ln, Suite 2B, Napa, CA 94558, USA. mbodormd@sbcglobal.net
Flossman
Tiffany
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D005385:Fingers / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods; D008012:Lidocaine / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D053401:Palmar Plate / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage* / Q000627:therapeutic use; D052582:Trigger Finger Disorder / Q000000981:diagnostic imaging* / Q000188:drug therapy; D018084:Ultrasonography, Interventional / Q000379:methods*
D008012:Lidocaine; D014222:Triamcinolone Acetonide