Closed division of the flexor tendon sheath for trigger finger

Lyu,

doi:10.1302/0301-620x.74b3.1587893

Cited by 44 publications

(39 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…7 The authors then dissected the fingers and found that the A1 pulley was not completely released in 32% of fingers. We believe that the low percentage of complete release of the A1 pulley in their study may be attributed to the use of insufficiently precise parameters, and that the use of more precise palmar surface landmarks such as measure A may yield more satisfactory results in percutaneous release with needles.…”

Section: Discussionmentioning

confidence: 99%

Anatomical Study of the A1 Pulley: Length and Location by Means of Cutaneous Landmarks on the Palmar Surface

Fiorini

Santos

Hirakawa

et al. 2011

The Journal of Hand Surgery

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Anatomical Study of the A1 Pulley: Length and Location by Means of Cutaneous Landmarks on the Palmar Surface

Fiorini

Santos

Hirakawa

et al. 2011

The Journal of Hand Surgery

View full text Add to dashboard Cite

“…The "blind" percutaneous technique uses surface anatomical landmarks [12][13][14][15][16][17][18][19][20][21][22]. Although it has been shown to be safe, it is complicated by incomplete release or the need to convert to an open release, which has been reported in up to 11% of cases [13,16,23].…”

Section: Discussionmentioning

confidence: 99%

“…Here, its tip is seen transecting the A1 pulley. Note how the operator can ensure that it remains dead centre over the flexor tendon under sonographic guidance during the procedure, particularly the digital nerves which have been shown to have a variable course in cadaveric studies [12][13][14][15][16][17][18][19][20][21][22]. Several studies suggest the variation in digital nerve position in the thumb, index and little finger puts non-image-guided percutaneous release at risk of complications [6,8,12,16,20,[24][25][26].…”

Section: Discussionmentioning

confidence: 99%

“…Whilst the results of their study were encouraging with no reported complications, they used a customised hook knife to perform the release that is not readily available and would represent an added expense of the procedure ($15 per knife) [4]. In contrast, we used a modified 19-gauge (white) needle as the cutting device which is cheap, widely available and used for blind percutaneous release of the annular pulley [3,8,13,16,20,23,27,28].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Ultrasound-guided percutaneous release of the annular pulley in trigger digit

et al. 2009

View full text Add to dashboard Cite

The purpose of this study was to describe and evaluate a new technique for ultrasound-guided percutaneous release of the annular pulley in trigger digit using a modified hypodermic needle. A total of 35 ultrasound-guided percutaneous releases were performed on 25 patients diagnosed and referred by hand surgeons in our institution over 16 months from October 2006. Inclusion criteria were as follows: adulthood, triggering present for at least 4 months, failure to respond to conservative management or steroid injections, no previous history of pulley release in the affected digit. Under ultrasound guidance, the affected pulley was released using a standard 19-gauge hypodermic needle bent at two points as the cutting device. Follow-up took place at 12 weeks and 6 months with improvement in triggering and clinically graded pain. At follow-up, no complications had occurred and all patients demonstrated improvement in their triggering, with complete resolution in 32 digits (91%), good improvement in 2 digits (6%) and some improvement in 1 digit (3%). This new technique uses a widely available and safe cutting device and is safe and can be used to provide definitive management for trigger finger, allowing the procedure to be performed in a variety of clinical settings.

show abstract

“…Sonographic monitoring with a special cutting instrument, kept deadcentre over the flexor tendon sheath (Ha et al, 2001;Lyu, 1992) and performed with a custom-made needle Clinical picture (C) and transverse sections of sonograms (D) of the long finger with grade IV trigger digit after the procedure. mur et al, 1998;Patel and Moradia, 1997;Tanaka et al, 1990) allowed observation during the division.…”

Section: Article In Pressmentioning

confidence: 99%

Sonographically Assisted Percutaneous Release of the A1 Pulley: A New Surgical Technique for Treating Trigger Digit

Jou

Chern

2006

Journal of Hand Surgery

107

View full text Add to dashboard Cite

This study introduces a sonographically assisted percutaneous technique for releasing trigger digits which provides direct visualization of the release and avoids the risks of incomplete release and injury to adjacent neurovascular structures associated with other percutaneous release techniques. The "safe zone" and an estimate of the size of the A1 pulley were determined in a separate cadaver study. We then used these landmarks in a prospective clinical study of 107 digits in 83 consecutive patients treated by this technique. During the follow-ups of between 9 and 15 months, we evaluated 104 digits in 80 patients. Pain was absent in 101 digits (97%) and considerably improved in the other three (3%). All mechanical problems had been resolved and none recurred during follow-up. This technique allows the surgeon to see and monitor, precisely, the percutaneous division of the A1 pulley without open surgery and, therefore, to avoid the inherent risks of percutaneous and open surgical release.

show abstract

Closed division of the flexor tendon sheath for trigger finger

Cited by 44 publications

References 4 publications

Anatomical Study of the A1 Pulley: Length and Location by Means of Cutaneous Landmarks on the Palmar Surface

Anatomical Study of the A1 Pulley: Length and Location by Means of Cutaneous Landmarks on the Palmar Surface

Ultrasound-guided percutaneous release of the annular pulley in trigger digit

Sonographically Assisted Percutaneous Release of the A1 Pulley: A New Surgical Technique for Treating Trigger Digit

Contact Info

Product

Resources

About