Antegrade Ultrasound-Guided Percutaneous Release of Trigger Thumb

Trigger finger is a common hand condition, with surgical treatment primarily based on the release of the A1 pulley. While open surgery remains the gold standard, ultrasound-guided percutaneous techniques have demonstrated their advantages due to their minimally invasive nature and their positive impact on recovery. However, in the case of trigger thumb, these techniques present specific challenges, particularly due to the proximity of neurovascular structures and constraints related to instrument orientation. The objective of this paper is to describe a novel axial and antegrade ultrasound-guided percutaneous approach for the release of the A1 pulley in trigger thumb, aiming to enhance procedural accuracy while minimizing iatrogenic risks. This technique is based on an antegrade minimally invasive release with an axial orientation under real-time ultrasound guidance, without reliance on theoretical bony landmarks. This approach enables optimized visualization of anatomical structures and precise control of the instrument's trajectory. It could serve as an additional alternative to existing strategies for the treatment of trigger thumb. The axial and antegrade ultrasound-guided percutaneous approach appears to be a promising technique for trigger thumb release. Further studies are required to evaluate its clinical efficacy, feasibility, postoperative recovery, and safety on a larger scale.