Ultrasound-Guided Percutaneous Release of the Trigger Thumb

Park,  Kwang Hee; Shin,  Won Jung; Lee,  Dong Ho; Kim,  Jong Pil

doi:2016.21.4.218

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Arch Hand Microsurg > Volume 21(4); 2016 > Article

Original Article

Journal of the Korean Society for Surgery of the Hand 2016;21(4):218-224.
Published online December 30, 2016.
DOI: https://doi.org/10.12790/jkssh.2016.21.4.218

Ultrasound-Guided Percutaneous Release of the Trigger Thumb

Kwang Hee Park, Won Jung Shin, Dong Ho Lee, Jong Pil Kim

¹Department of Orthopaedic Surgery, Dankook University College of Medicine, Cheonan, Korea. kimjp@dankook.ac.kr
²Department of Kinesiology and Medical Science, Graduate School, Dankook University, Cheonan, Korea.

Received: 30 August 2016 • Revised: 9 November 2016 • Accepted: 10 November 2016

Abstract

Purpose
Trigger thumb is a common condition with a prevalence rate up to 3% among the adults. The main pathophysiology is locking of the flexor tendon at the A1 pulley. Treatments include nonsteroidal anti-inflammatory drug, steroid injection, and surgical A1 pulley release. The purpose of this study was to evaluate the safety and effectiveness of ultrasound-guided percutaneous release of trigger thumb.

Methods
The author prospectively reviewed 37 patients who had undergone ultrasound-guided percutaneous release by the same surgeon from January 2012 to June 2014. The effect of ultrasound-guided A1 pulley release was evaluated by using visual analogue scale (VAS) score, disabilities of arm, shoulder, and hand (DASH) score, and grip and pinch strengths preoperatively and at 12weeks after the surgery. In addition, complications related with the procedure were evaluated.

Results
Triggering and locking were resolved in all patients after surgery. VAS and DASH improved from 5.0±1.8 and 45.8±16.9 preoperatively to 0.3±0.6 and 16.2±6.3 at 12 weeks, respectively (p=0.019 and p=0.021). Grip and pinch strengths statistically improved from33.5±8.6 kg and 36.7±8.1 kg, preoperatively 46.2±6.1 kg and 47.1±7.4 kg, respectively (p=0.026 and p=0.041). Complications such as incomplete resection, neurologic symptoms or wound infection were not found throughout the period of the study.

Conclusion
Ultrasound-guided percutaneous A1 pulley release provides complete relief of symptoms with no major complication in trigger thumb.

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