Comparative study of ultrasonography-guided percutaneous A1 pulley release versus blinded percutaneous A1 pulley release

Lee, Sung Hyun; Choi, Young Chae; Kang, Hong Je

doi:10.1177/2309499018772368

Cited by 23 publications

(42 citation statements)

References 19 publications

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“…According to the degree of entrapment between the flexor digitorum tendon and tendon sheath, TF are divided into five grades (Lapègue et al, 2016; Lee et al, 2018) (clinical semi-quantitative evaluation criteria): (1) Grade 0: no triggering; (2) Grade 1: intermittent, moderate triggering; (3) Grade 2: continuous triggering that is eliminated with active extension; (4) Grade 3: triggering with flexion contracture that requires the patient to use the other hand to unlock the involved finger; (5) Grade 4: active flexion of finger is impossible.…”

Section: Methodsmentioning

confidence: 99%

“…However, there is still a potential risk of damage to the tendon and neurovascular structures. Also, it is difficult to confirm whether the release is complete or not during operation because of invisualization directly (Lee et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

“…However, it was reported that the gauge needles can be twisted easily and the sharp tip might increase the possibility of hurting the surrounding tissues. Specially designed knives have been used for percutaneous release, including the knife with a hook shape or with long body (Nikolaou et al, 2017; Lee et al, 2018). A success rate of 100% using this knife was achieved in ultrasonography-guided percutaneous release.…”

Section: Introductionmentioning

confidence: 99%

“…For example, inexperience of the operator and anatomical variation of the patient can lead to accidental injury to the flexor tendon or adjacent neurovascular bundles, as well as difficulty in determining the completeness of release. In addition, a vertical insertion from above the skin surface may increase the risk of nerve and the flexor tendon damage (Ma and Wu, 2016; Lee et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound-Guided Percutaneous Release of A1 Pulley by Using a Needle Knife: A Prospective Study of 41 Cases

Pan

Sheng²,

Fan

et al. 2019

Front. Pharmacol.

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Objective: The purpose of this study was to evaluate the efficacy of ultrasonography-guided percutaneous A1 pulley release with the needle knife for trigger finger. Methods: The prospective study included 21 patients (21 fingers) who underwent blind release with the needle knife and 20 patients (20 fingers) who underwent ultrasonography-guided release with the needle knife. The thickness and width of A1 pulley, clinical grade before and after release, complications, and operation time were compared between the groups. Results: The results showed that the ultrasonography-guided group had significantly better grade postoperatively and reached to 100% complete release in one time compared to the blind group ( p < 0.05). Moreover, no any complications had been happened in the ultrasonography-guided group. A relatively longer operation time of the ultrasonography-guided group was observed compared to the time of the blind group. Conclusions: The needle knife is a very good tool for release of triggering fingers. Ultrasound provides a direct and precise visualization of the thickness, width and location of A1 pulley lesion. The combined use of ultrasound and the needle knife can achieve the best result for trigger finger. Moreover, the combination changes the traditional opinion and operator-dependent mode that were once widely adopted in the hospital of Chinese Medicine.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Ultrasound-Guided Percutaneous Release of A1 Pulley by Using a Needle Knife: A Prospective Study of 41 Cases

Pan

Sheng²,

Fan

et al. 2019

Front. Pharmacol.

View full text Add to dashboard Cite

show abstract

“…Though blind percutaneous release can be done without any special preparation and can obtain the effect equal to that of an open procedure [14] there is still a potential risk of damage to the tendon and neurovascular structures. Also, it is di cult to con rm whether the release is complete or not during the operation [15].…”

Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Ultrasonography-Guided Corticosteroid Injection Combined with Versus Without Needle Knife Release of A1 Pulley for Trigger Finger

Chen

et al. 2021

Preprint

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Background: Although corticosteroid injection remains a common first-line treatment of trigger finger, but not all cases of trigger finger respond the same. This study aims to compare the clinical effectiveness of ultrasonography-guided corticosteroid injection with and without needle knife release of A1 pulley in treating trigger finger. Methods: 49 patients with trigger fingers (55 fingers, thumb) were included in this study. 28 fingers underwent ultrasonography-guided corticosteroid injection plus needle knife release of A1 pulley (combination group), and 27 fingers underwent only ultrasonography-guided needle knife release of A1 pulley (monotherapy group). Visual analogue scale (VAS), Froimson scale, postoperative recurrence rate, and thickness of A1 pulley in pre-operation and follow-up period were recorded. Results: Higher clinical amelioration and clinical cure rate were observed in combination group at 2 weeks after treatment among patients with Froimson scale Grade III and IV (p<0.05). Among Grade IV patients, combination group had narrower thickness of A1 pulley and better pain relief at 2 weeks postoperatively (all p<0.05). There was no significant difference regarding the values of clinical amelioration rate, clinical cure rate, thickness of the A1 pulley, pain relief and recurrence rate between the two groups at 12 week and 6 months postoperatively (all p>0.05). Conclusion: Ultrasonography-guided corticosteroid injection combined with needle knife release of A1 pulley had superiority in early-stage pain relief and narrowing the thickness of A1 pulley than single needle knife release, but its medium and long-term effects were not obvious.

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Ultrasound Features of Trigger Finger: Review of the Literature

Bianchi¹,

Gitto

Draghi

2019

J of Ultrasound Medicine

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Trigger finger is a common pathologic condition of the digital pulleys and flexor tendons in the hand. The key clinical finding is a transient blockage of the digit when it is flexed with subsequent painful snapping when it is extended. Imaging is a helpful guide for establishing the severity of the disease, identifying the underlying cause, and deciding the appropriate management. This narrative review aims to recall the anatomic and pathologic bases and describe the ultrasound features of trigger finger, also including common ultrasound findings and complications after therapy. Ultrasound enables an accurate static and dynamic evaluation of trigger finger as well as a comparison with the adjacent normal digits and thus should be considered the radiologic modality of first choice for its diagnosis.

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Comparative study of ultrasonography-guided percutaneous A1 pulley release versus blinded percutaneous A1 pulley release

Abstract: Ultrasonography-guided percutaneous A1 pulley release for treatment of trigger finger reduces postoperative pain and complications, such as incomplete release, compared with a blind procedure.

Cited by 23 publications

References 19 publications

Ultrasound-Guided Percutaneous Release of A1 Pulley by Using a Needle Knife: A Prospective Study of 41 Cases

Ultrasound-Guided Percutaneous Release of A1 Pulley by Using a Needle Knife: A Prospective Study of 41 Cases

WITHDRAWN: Ultrasonography-Guided Corticosteroid Injection Combined with Versus Without Needle Knife Release of A1 Pulley for Trigger Finger

Ultrasound Features of Trigger Finger: Review of the Literature

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