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KMID : 0356920090560010060
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Korean Journal of Anesthesiology
2009 Volume.56 No. 1 p.60 ~ p.65
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Clinical experience of the percutaneous release for trigger fingers
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Ryu Han-Koo
Lee Sang-Gon
Min Byung-Woo
Ban Jong-Seouk
Lee Ji-Hyang
Kim Eun-Ju
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Abstract
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Background: Conservative management for the trigger fingers includes splinting, steroid injection and other adjuvant methods. If conservative treatment fails, a surgical release of the A1 pulley is offered. Although the success rate of the surgical intervention is high, the complications, for example, a digital nerve injury, bowstringing, infection and continued triggering, have been reported. Percutaneous release with an 18 guage needle has been reported as a safe and effective procedure for the trigger fingers. This study evaluates the safety and efficacy of the percutaneous release.
Methods: 33 patients received the percutaneous release of the A1 pulley with an 18 guage needle and steroid injection (Group A) and 36 patients did the only administration of steroid as a control group (Group B). Patients were examined with a clinical staging for the Watanabe stage (W stage) and 0?10 points verbal numerical rating scale (VNRS) score at 1 week, 3 months, 1 year after the initial treatment.
Results: After 1 year of the follow-up, 93.5% in the group A and 57.6% in the group B had complete release of the trigger fingers in the W stage. VNRS after the initial treatment demonstrated that the decrement of the pain score was more significant in the group A.
Conclusions: We need to consider the percutaneous release with steroid injection at an early stage of the trigger fingers because of the more effective resolution of the symptoms and the better long-term prognosis than a steroid injection alone. (Korean J Anesthesiol 2009; 56: 60∼5)
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KEYWORD
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Percutaneous release, Steroid injection, Trigger finger, Watanabe stage
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