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Percutaneous Release of Trigger Digits.

Noah D Weiss1, Madeline B Richter

  • 1Weiss Orthopaedics, Sonoma, CA. nweiss@weissortho.com.

American Journal of Orthopedics (Belle Mead, N.J.)
|September 1, 2017
PubMed
Summary
This summary is machine-generated.

Percutaneous release effectively treats trigger finger (stenosing flexor tenosynovitis) with a 90.1% success rate. This minimally invasive method offers a safe, economical alternative to open surgery, avoiding complications like infection or nerve damage.

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Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Minimally Invasive Procedures

Background:

  • Stenosing flexor tenosynovitis, commonly known as trigger finger, presents a significant clinical challenge.
  • Traditional treatments include open, endoscopic, and percutaneous tendon sheath incisions, each with varying outcomes and recovery profiles.
  • Open surgery, while effective, is associated with higher costs, longer procedure times, and extended postoperative recovery.

Purpose of the Study:

  • To evaluate the efficacy and safety of percutaneous tendon sheath incision as a primary treatment for trigger digits.
  • To compare the outcomes of percutaneous release with established surgical methods for trigger finger.

Main Methods:

  • A retrospective study was conducted over a 10-year period, involving a single surgeon treating 596 trigger digits in 429 patients.
  • Treatment involved percutaneous tendon sheath incisions.
  • Successful release was defined by symptom resolution or patient's decision to forgo further treatment.

Main Results:

  • A high success rate of 90.1% (537 out of 596 digits) was achieved with percutaneous release.
  • Among the 59 failures, subsequent treatments (repeat percutaneous or open surgery) led to overall high success rates.
  • No significant differences in digit success rates were observed, and importantly, no complications such as infection, chronic pain, or tendon/neurovascular damage were reported.

Conclusions:

  • Percutaneous tendon sheath incision is a safe and effective treatment for trigger digits.
  • This minimally invasive approach offers comparable success rates to open surgery but with improved economic and recovery profiles.
  • It represents a viable, cost-effective alternative for managing trigger finger, minimizing risks associated with more invasive procedures.