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Ultrasound-Guided A1 Pulley Release Versus Classic Open Surgery for Trigger Digit: A Randomized Clinical Trial.

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Ultra-minimally Invasive Sonographically-guided Trigger Digit Release: An External Pilot Study.

Guillermo Rodríguez-Maruri1, Jose Manuel Rojo-Manaute2, Alberto Capa-Grasa3

  • 1Department Physical and Rehabilitation Medicine, University Hospital Marqués de Valdecilla, Santander, Spain.

Oman Medical Journal
|April 11, 2022
PubMed
Summary

Sonographically-guided intrasheath release for trigger digit (TD) is safe and effective, showing better functional recovery than open surgery. This pilot study confirms the feasibility of a future clinical trial for this minimally invasive technique.

Keywords:
SurgeryTrigger Finger DisorderUltrasonography, Interventional

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Area of Science:

  • Orthopedic Surgery
  • Musculoskeletal Disorders
  • Medical Imaging

Background:

  • Classic open surgery and blind percutaneous release for trigger digit (TD) present risks of complications and incomplete results.
  • Intrasheath sonographically-guided first annular pulley release offers a potentially safer and more effective alternative.

Purpose of the Study:

  • To compare intrasheath sonographically-guided release with classic open surgery for trigger digit.
  • To assess the feasibility of conducting a future clinical trial on this technique.

Main Methods:

  • A pilot study randomized 30 patients with Grade III trigger digit to either sonographically-guided release (1 mm incision) or classic open surgery (1 cm incision).
  • Outcomes included safety, efficacy, recruitment rates, compliance, and QuickDASH scores, with blinded outcome assessment.

Main Results:

  • Both techniques achieved symptom resolution without complications.
  • The sonographically-guided group demonstrated significantly better QuickDASH scores up to six weeks post-operation.
  • Feasibility objectives were met, indicating a future clinical trial with 84 patients is viable.

Conclusions:

  • Intrasheath sonographically-guided release is a safe and effective treatment for trigger digit, with a trend towards clinical superiority over open surgery.
  • A randomized clinical trial is feasible and recommended to confirm these findings.