PERCUTANEOUS RELEASE OF TRIGGER FINGER WITH L SHAPED HOLLOW NEEDLE KNIFE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANG Huimin , ZENG Haobin , WU Hansheng , SHEN Qingliang , CAI Cailiang , CHEN Wenzhi , WU Hanqin.

Department of Orthopedics, the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou Guangdong, 510370, P.R.China.;

Corresponding author：

Keywords：

L shaped hollow needle knife，Trigger finger，Minimally invasive technique

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【Abstract】 Objective To investigate the effectiveness of a percutaneous release with L shaped hollow needle knife in treating trigger finger. Methods Between September 2007 and September 2009, 160 patients with trigger fingers (202 fingers) were treated by percutaneous release with L shaped hollow needle knife. There were 47 males and 113 females with a mean age of 55 years (range, 12-68 years). The disease duration was 2 weeks to 1 year. Affected fingers included 58 thumbs, 20 index fingers, 46 middle fingers, 60 ring fingers, and 18 little fingers. According to Quinnell grading, 63 fingers were classified as grade III, 126 fingers as grade IV, and 13 fingers as grade V. A1 pulley was released during operation and steroid was injected after release procedure using the same needle. Results The mean operation time was 8.2 minutes (range, 5-19 minutes), and no complication occurred. All the patients were followed up 1 year to 3 years and 6 months (mean, 1.6 years). The patients still felt pain in 36 fingers at 1 week after operation, which were relieved after oral administration of non-steroidal anti-inflammatory drug. Twenty-five fingers had snapping or locking in flexion-extension motion; 5 fingers recovered at 1 month after operation and 20 fingers had no obvious improvement; of 20 fingers, symptom was alleviated in 10 fingers, and was not alleviated in 10 fingers after re-release with L shaped hollow needle knife. According to Quinnell grading for efficacy evaluation at 6 months after operation, the results were excellent in 165 fingers, good in 27 fingers, poor in 10 fingers with an excellent and good rate of 95.0%. Conclusion The percutaneous release with L shaped hollow needle knife is a safe and effective procedure in treating trigger finger with low complications.

Citation： WANG Huimin,ZENG Haobin,WU Hansheng,SHEN Qingliang,CAI Cailiang,CHEN Wenzhi,WU Hanqin.. PERCUTANEOUS RELEASE OF TRIGGER FINGER WITH L SHAPED HOLLOW NEEDLE KNIFE. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(1): 14-16. doi: Copy

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12.	Wilhelmi BJ, Snyder N 4th, Verbesey JF, et al. Trigger finger release with hand surface landmark ratios: an anatomic and clinical study. Plast Reconstr Surg, 2001, 108(4): 908-915.
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14.	Lorthioir J Jr. Surgical treatment of trigger finger by a subcutaneous method. J Bone Joint Surg (Am), 1958, 40-A(4): 793-795.
15.	Wang HC, Lin GT. Retrospective study of open versus precutaneous.

1. the ‘life-cut’ technique. Br J Plast Surg, 2005, 58(3): 817-821.
2. technique. J Hand Surg (Br), 2004, 29(5): 502-505.
3. surgery for trigger thumb in Children. Plast Reconstr Surg, 2005, 115(7): 1963-1970.
4. Clapham PJ, Chung KC. A historical perspective of the Notta’s node in trigger fingers. J Hand Surg (Am), 2009, 34(8): 1518-1522.
5. Maneerit J, Sriworakun C, Budhraja N, et al. Trigger thumb: results of a prospective randomised study of precutaneous release with steroid injection versus steroid injection alone. J Hand Surg (Br), 2003, 28(6): 586-589.
6. Ragoowansi R, Acornley A, Khoo CT. Percutaneous trigger finger release:.
7. Miyamoto H, Miura T, Isayama H, et al. Stiffness of the first annular pulley in normal and trigger fingers. J Hand Surg (Am), 2011, 36(9): 1486-1491.
8. Lee WT, Chong AK. Outcome study of open trigger digit release. J Hand Surg Eur Vol, 2011, 36(4): 339.
9. Marek DJ, Fitoussi F, Bohn DC, et al. Surgical release of the pediatric trigger thumb. J Hand Surg (Am), 2011, 36(4): 647-652. e2.
10. Park MJ, Oh I, Ha KI. A1 pulley release of locked trigger digit by percutaneous.
11. Pope DF, Wolfe SW. Safety and efficacy of precutaneous trigger finger release. J Hand Surg (Am), 1995, 20(2): 280-283.
12. Wilhelmi BJ, Snyder N 4th, Verbesey JF, et al. Trigger finger release with hand surface landmark ratios: an anatomic and clinical study. Plast Reconstr Surg, 2001, 108(4): 908-915.
13. Hazani R, Engineer NJ, Zeineh LL, et al. Assessment of the distal extent of the A1 pulley release: a new technique. Eplasty, 2008, 8: e44.
14. Lorthioir J Jr. Surgical treatment of trigger finger by a subcutaneous method. J Bone Joint Surg (Am), 1958, 40-A(4): 793-795.
15. Wang HC, Lin GT. Retrospective study of open versus precutaneous.

Chinese Journal of Reparative and Reconstructive Surgery

PERCUTANEOUS RELEASE OF TRIGGER FINGER WITH L SHAPED HOLLOW NEEDLE KNIFE

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