Safety and efficacy of percutaneous trigger finger release

Twenty-five A1 pulleys in 5 fresh cadaveric hands and 13 trigger fingers in 11 patients were released percutaneously with a 19 gauge needle, as described by Eastwood et al., to determine the efficacy and safety of the technique. Over 90% of the length of each individual finger and thumb A1 pulley were successfully released in the cadaveric digits with no injuries to the A2 pulley, nerves, or vessels. Superficial abrasions were noted in four superficialis tendons. In our surgical series, complete clinical release (eradication of triggering) was achieved in each digit. In 8 of 13 digits, the A1 pulley was found to be completely divided on open exploration. In five digits, while triggering was eliminated, some of the A1 pulley remained intact. There were no complications. Because of the proximity of digital nerves, we do not perform percutaneous release in the index finger or thumb.