Comparative Study of Functional Outcome of Open Versus Percutaneous Release of A1 Pulley for Trigger Finger

Hamal B*, Rai RK*, Thapa S*, Bisht R**, Bajracharya AR***


Introduction: Trigger finger is caused by entrapment of flexor tendon by thickening at entrance to its sheath especially at A1 pulley; on forced extension it passes the constriction with a snap(‘triggering’)conservative management of trigger finger consists of NSAIDs, splinting and steroid injection into the tendon sheath. Failure of conservative management is indication of surgical release. Surgical release can be done by open or percutaneous methods. The functional outcome of open versus percutaneous release has not been studied in our set up. So the purpose of this prospective study is to compare the functional outcome of open versus percutaneous release of A1 pulley of trigger finger.

Method: This was a prospective observational study done in Bir Hospital, NAMS in total 60 patients. Open release was done in 30 patients and percutaneous release in 30 patients. Pre operative, 1 week post operative and 12 week postoperative pain by Visual analogue Scale (VAS) score, range of motion and post operative complications were compared in both groups. result: There was no significant difference in functional outcome in both the groups.

Conclusion: We concluded that functional outcome is equally good in both the groups, however due to lesser expenses, less morbidity, less risks of wound complications percutaneous release may be better choice of procedure.

Full Text: