Percutaneous trigger finger release

Percutaneous trigger finger release

I have started performing out patient trigger finger release on middle and ring fingers that have active demonstrable triggering on flexing the finger. This is not suitable for those patients who have intermittent triggering.

The results are immediate with abolition of the triggering confirmed by asking the patient to maximally flex the finger.

The procure is very simple and takes approximately 5-10 mins to perform.

A small amount of local anaesthetic is injected in the palm at the level of the trigger nodule. Once numb a small needle is used to cut the constricting band of tissue (pulley) underneath which the tendon is catching. The needle cuts the band and the patient flexes the finger until no further catching occurs.

A simple spot plaster is placed over the injection site and normal activities can resume immediately. The finger is sore for a week or so and simple over the counter pain killers are needed for the first few days.

This is a simple procedure with a minimal risk of infection, damaging nerves and blood vessels to the finger causing numbness and bleeding. The main risk is inadequate release of the pulley and it is for this reason that in my practice the procedure is only performed on those patients can demonstrate in clinic triggering so I know when I have release the pulley sufficient to prevent triggering.

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