Percutaneous Trigger Release in Non-Triggering Digits: Infiltration of Normal Saline into Tendon Substance to Induce Triggering

Abstract

Percutaneous trigger release is recognized as an effective minimally invasive procedure with a low complication rate. One prerequisite for percutaneous trigger release is a trigger of Quinnell Type II or higher; that is, a digit that is actively triggering. We describe an additional step in percutaneous trigger release, which enables the surgeon to perform the procedure in digits that are not actively triggering at the point of surgery. This step involves the infiltration of normal saline into the tendon substance distal to the A1 pulley in order to induce triggering.

Keywords

Percutaneous trigger release - Pulley release - Needle - Normal saline infiltration

• References

• 1 Sato ES, dos Santos JB, Belloti JC et al Percutaneous release of trigger fingers. Hand Clin 2014; 30 (1) 39-45
• 2 Dierks U, Hoffmann R, Meek MF. Open versus percutaneous release of the A1-pulley for stenosing tendovaginitis: a prospective randomized trial. Tech Hand Up Extrem Surg 2008; 12 (3) 183-187
• 3 Schramm JM, Nguyen M, Wongworawat MD. The safety of percutaneous trigger finger release. Hand (N Y) 2008; 3 (1) 44-46
• 4 Habbu R, Putnam MD, Adams JE. Percutaneous release of the A1 pulley: a cadaver study. J Hand Surg [Am] 2012; 37 (11) 2273-2277
• 5 Bain GI, Turnbull J, Charles MN et al Percutaneous A1 pulley release: a cadaveric study. J Hand Surg 1995; 20: 781-784
• 6 Pope DF, Wolfe SW. Safety and efficacy ofpercutaneous trigger finger release. J Hand Surg 1995; 20A: 280-283
• 7 Wilhelmi BJ, Snyder 4th N, Verbesey JE et al Trigger finger release with hand surface landmark ratios: an anatomic and clinical study. Plast Reconstr Surg 2001; 108 (4) 908-915