Ultrasound‐guided microinvasive trigger finger release technique using an 18‐gauge needle with a blade at the tip: A prospective study
Background Open surgical trigger finger release has limited success and the risk of complications; however, percutaneous techniques offer a successful alternative. There is limited understanding of the success of percutaneous trigger finger release. Objective To prospectively evaluate the functional...
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Published in | PM & R Vol. 14; no. 8; pp. 963 - 970 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
Hoboken, USA
John Wiley & Sons, Inc
01.08.2022
|
Online Access | Get full text |
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Abstract | Background
Open surgical trigger finger release has limited success and the risk of complications; however, percutaneous techniques offer a successful alternative. There is limited understanding of the success of percutaneous trigger finger release.
Objective
To prospectively evaluate the functional outcomes of patients with Green classification Grade 2 to 4 trigger finger treated with an ultrasound‐guided microinvasive trigger finger release using a special 18‐gauge needle with a blade at the tip.
Design
Prospective, case‐series study.
Setting
This study took place at an academic institution by one sports medicine physician (R.E.C.) with subspecialty training and certification in musculoskeletal ultrasound.
Patients
Sixty patients (79 cases) met criteria and agreed to participate in this study; 19 patients had multiple fingers treated. Average patient age was 62.8 years (SD 10.2). Average trigger finger severity diagnosis was Grade 3.
Interventions
Patients were treated with an ultrasound‐guided microinvasive trigger finger release using a special 18‐gauge needle with a blade at the tip.
Main Outcome Measurements
Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), numerical rating scale (NRS), and Nirschl scores were captured preprocedure, at various time points, and at final follow‐up. Changes between preprocedure and final follow‐up were analyzed by paired t test (p < .05). Differences were also analyzed between finger, grade level, and gender by repeated measures analyses of variance (p < .05).
Results
No adverse events were documented perioperatively or postoperatively. Average follow‐up time was 18.4 months (SD 4.6). At final follow‐up, 100% of patients reported no recurrence of catching/locking, 97% had complete resolution of symptoms and significant improvement in QuickDASH scores, and 99% required no further treatment. All measurements showed a decrease in pain and symptoms over time. The improvements in QuickDASH score, NRS, and Nirschl scale and the resolution of mechanical symptoms were all statistically significant.
Conclusions
Ultrasound‐guided release using the 18‐gauge needle with a blade provides significant functional improvement and full resolution of mechanical symptoms with minimal adverse events. |
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AbstractList | BACKGROUNDOpen surgical trigger finger release has limited success and the risk of complications; however, percutaneous techniques offer a successful alternative. There is limited understanding of the success of percutaneous trigger finger release. OBJECTIVETo prospectively evaluate the functional outcomes of patients with Green classification Grade 2 to 4 trigger finger treated with an ultrasound-guided microinvasive trigger finger release using a special 18-gauge needle with a blade at the tip. DESIGNProspective, case-series study. SETTINGThis study took place at an academic institution by one sports medicine physician (R.E.C.) with subspecialty training and certification in musculoskeletal ultrasound. PATIENTSSixty patients (79 cases) met criteria and agreed to participate in this study; 19 patients had multiple fingers treated. Average patient age was 62.8 years (SD 10.2). Average trigger finger severity diagnosis was Grade 3. INTERVENTIONSPatients were treated with an ultrasound-guided microinvasive trigger finger release using a special 18-gauge needle with a blade at the tip. MAIN OUTCOME MEASUREMENTSQuick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), numerical rating scale (NRS), and Nirschl scores were captured preprocedure, at various time points, and at final follow-up. Changes between preprocedure and final follow-up were analyzed by paired t test (p < .05). Differences were also analyzed between finger, grade level, and gender by repeated measures analyses of variance (p < .05). RESULTSNo adverse events were documented perioperatively or postoperatively. Average follow-up time was 18.4 months (SD 4.6). At final follow-up, 100% of patients reported no recurrence of catching/locking, 97% had complete resolution of symptoms and significant improvement in QuickDASH scores, and 99% required no further treatment. All measurements showed a decrease in pain and symptoms over time. The improvements in QuickDASH score, NRS, and Nirschl scale and the resolution of mechanical symptoms were all statistically significant. CONCLUSIONSUltrasound-guided release using the 18-gauge needle with a blade provides significant functional improvement and full resolution of mechanical symptoms with minimal adverse events. Background Open surgical trigger finger release has limited success and the risk of complications; however, percutaneous techniques offer a successful alternative. There is limited understanding of the success of percutaneous trigger finger release. Objective To prospectively evaluate the functional outcomes of patients with Green classification Grade 2 to 4 trigger finger treated with an ultrasound‐guided microinvasive trigger finger release using a special 18‐gauge needle with a blade at the tip. Design Prospective, case‐series study. Setting This study took place at an academic institution by one sports medicine physician (R.E.C.) with subspecialty training and certification in musculoskeletal ultrasound. Patients Sixty patients (79 cases) met criteria and agreed to participate in this study; 19 patients had multiple fingers treated. Average patient age was 62.8 years (SD 10.2). Average trigger finger severity diagnosis was Grade 3. Interventions Patients were treated with an ultrasound‐guided microinvasive trigger finger release using a special 18‐gauge needle with a blade at the tip. Main Outcome Measurements Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), numerical rating scale (NRS), and Nirschl scores were captured preprocedure, at various time points, and at final follow‐up. Changes between preprocedure and final follow‐up were analyzed by paired t test (p < .05). Differences were also analyzed between finger, grade level, and gender by repeated measures analyses of variance (p < .05). Results No adverse events were documented perioperatively or postoperatively. Average follow‐up time was 18.4 months (SD 4.6). At final follow‐up, 100% of patients reported no recurrence of catching/locking, 97% had complete resolution of symptoms and significant improvement in QuickDASH scores, and 99% required no further treatment. All measurements showed a decrease in pain and symptoms over time. The improvements in QuickDASH score, NRS, and Nirschl scale and the resolution of mechanical symptoms were all statistically significant. Conclusions Ultrasound‐guided release using the 18‐gauge needle with a blade provides significant functional improvement and full resolution of mechanical symptoms with minimal adverse events. |
Author | Fleisig, Glenn S Jurado Vélez, Javier A. Garrett, William Hunter Colberg, Ricardo E. Hart, Karen |
Author_xml | – sequence: 1 givenname: Ricardo E. orcidid: 0000-0001-6037-0829 surname: Colberg fullname: Colberg, Ricardo E. email: ricardo.colberg@andrewssm.com organization: American Sports Medicine Institute – sequence: 2 givenname: Javier A. orcidid: 0000-0003-3280-3142 surname: Jurado Vélez fullname: Jurado Vélez, Javier A. organization: Andrew's Sports Medicine and Orthopedic Center – sequence: 3 givenname: William Hunter surname: Garrett fullname: Garrett, William Hunter organization: American Sports Medicine Institute – sequence: 4 givenname: Karen surname: Hart fullname: Hart, Karen organization: American Sports Medicine Institute – sequence: 5 givenname: Glenn S surname: Fleisig fullname: Fleisig, Glenn S organization: American Sports Medicine Institute |
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Cites_doi | 10.1155/2017/9539206 10.1016/S0363-5023(05)80195-9 10.1016/J.JHSB.2005.11.003 10.1016/j.jhsa.2004.10.011 10.1053/jhsu.2001.24967 10.1016/j.hansur.2016.02.004 10.7863/jum.2010.29.11.1517 10.1007/s00330-009-1397-3 10.1016/j.ultrasmedbio.2016.02.017 10.5435/JAAOS-D-16-00042 10.2106/JBJS.G.00693 10.1007/s11552-014-9716-9 10.1080/00913847.2018.1400897 10.5312/wjo.v8.i2.163 10.1016/j.jhsa.2009.12.040 10.1177/1753193416682917 10.1016/0266-7681(88)90138-6 10.1016/j.jhsa.2017.02.011 10.7863/jum.2012.31.3.417 10.1142/S0218810403001820 10.7863/jum.2010.29.11.1531 10.1097/PHM.0000000000001510 10.1016/j.jhsa.2014.07.044 10.7863/jum.2012.31.3.427 10.1016/j.jhsa.2017.02.001 10.1142/S0218810405002449 10.1148/radiol.2016151886 10.1136/bmj.331.7507.30 10.1002/jor.20825 |
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