Transition From Open Trigger Finger Release to Micro-incision Trigger Finger Release Under Real-Time Ultrasound...

Purpose The primary objective of this review was to report the results of trigger finger release (TFR) under real-time ultrasound (US) guidance in a real-world population, including patients with concomitant hand issues and other comorbidities. Method A retrospective review of the corresponding author's case log for 2023 was conducted to identify all patients who underwent an index, middle, ring, or little finger micro-incision TFR from February through September of that year under real-time US guidance (ultrasound TFR (uTFR)). The preoperative demographics collected included triggering severity, comorbidities, age, and sex. The postoperative course included the number and type of postoperative visits required and notation of intraoperative or postoperative complications. Results Overall, 209 TFRs were performed on 116 consecutive patients using uTFR. There were no revision surgeries, nerve injuries, or infections. One digit required an intraoperative conversion to an open TFR (oTFR) with flexor digitorum superficialis (FDS) slip resection for persistent locking. Notably, 114 of the patients (98%) had at least one medical comorbidity or concomitant hand procedure at the time of uTFR. Furthermore, 113 patients (97%) were eligible for a streamlined follow-up process, and 104 (92%) elected to have only a telephone or registered nurse (RN) visit for follow-up after surgery. Seven patients (6%) had a post-procedure steroid injection on the operative digit, and 18 (16%) attended at least one occupational therapy (OT) visit. Conclusion Microincision uTFR appears to be safe for the index, middle, ring, and little fingers regardless of comorbidities. Multiple digits can be released at the same time, even under local anesthesia. The technique allows for a streamlined process for most patients and for the practice.