Three handred and fifty-four trigger fingers in 292 patients treated initially by percutaneus A-1 pulley release technique from July 1996 to May 1998 were reviewed retrospectively.
There were 255 (87.3%) females, 37 (12.7%) males, with a mean age of 52.4 (range 36-84 years). The Thumb was most frequently involved (159 digits), followed by middle finger (96), index finger (66), ring finger (30), and little finger (3).
They consisted of 242 (262 digits) idiopathic patients, 36 (74) hemodialysis, and 14 (18) rheumatoid arthritis.
Of the 354 trigger fingers, 339 (95.8%) had complete resolusion of triggering with the disappearance of snapping after percutaneus release. Reoperations (percutaneus or open surgery) were required in 12 (3.4%) fingers 9 for residual snapping after release, 2 for uneven movement with pain by the tendon nobule and incompletely released A-1 pulley, 1 for the narrow between the thick tendontheath and tendon nodule.
At reoperation, residual snapping and uneven movement were considered to be caused by incompletely release in 6 fingers, hypertrophy of the tenosynovium in 3, snapping in A-2 pulley in 2, and adhesion between the deep and superficial flexor tendons in 1.
Pain over 4 weeks after surgery was found in 19 fingers, and Metacarpo-phalangeal joint flexion iontracture like “Dupuy treins contrcture” occured in 3, but no infection and no neuro-vascular injury were seen.
We reccommend this technique for outpatients with trigger fingers, because of its safety, simplicity, few complication, and patient's satisfaction with high successful rate.
