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Related Experiment Video

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Ultrasound-guided trigger thumb release.

Francisco Javier Ferreira Villanova1, Vincent Martinel2, Olivier Marès3

  • 1Hand & Wrist Surgery Chief, Orthopedic Surgery Department, Hospital Universitario San Rafael, Madrid, Spain; International Chair of Musculoskeletal Ultrasound, UCAM, Murcia, Spain.

Hand Surgery & Rehabilitation
|January 17, 2025
PubMed
Summary

This study shows retrograde ultrasound-guided A1 pulley release effectively treats trigger thumb with significant pain reduction and improved function. The novel technique offers a safe alternative to open surgery, with rapid recovery and minimal complications.

Keywords:
Minimally invasive surgeryThumb triggerTrigger fingerUltrasound-guided procedureUltrasound-guided surgery

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Area of Science:

  • Orthopedics
  • Hand Surgery
  • Musculoskeletal Ultrasound

Background:

  • Trigger thumb, or stenosing tenosynovitis of the flexor pollicis longus, affects daily activities.
  • Traditional open A1 pulley release carries risks, including digital nerve injury.
  • Ultrasound-guided and percutaneous techniques offer potential advantages over open surgery.

Purpose of the Study:

  • To evaluate the efficacy and safety of a novel retrograde ultrasound-guided A1 pulley release for trigger thumb.
  • To compare outcomes with traditional surgical methods.

Main Methods:

  • Retrospective single-center study of 42 patients with clinically diagnosed trigger thumb.
  • Patients underwent retrograde ultrasound-guided A1 pulley release after failing conservative treatment.
  • Outcomes measured included pain (VAS), function (Quick-DASH), and complication rates.

Main Results:

  • All patients achieved resolution of triggering at one-month follow-up.
  • Significant improvement in mean VAS score (7.2 to 1.3) and Quick-DASH score (51 to 9.1).
  • No major complications were reported; faster recovery compared to open surgery.

Conclusions:

  • Retrograde ultrasound-guided A1 pulley release is an effective and safe treatment for trigger thumb.
  • This technique offers advantages such as improved cosmesis and immediate return to activities.
  • It presents a safer alternative to open surgery with comparable efficacy and fewer complications.