Sutter, Damian; Treier, Aline; Vögelin, Esther (2023). Sonographically controlled minimally-invasive A1 pulley release using a new guide instrument - a case series of 106 procedures in 64 patients. BMC musculoskeletal disorders, 24(1), p. 875. BioMed Central 10.1186/s12891-023-06982-x
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BACKGROUND
With percutaneous and minimally-invasive pulley release becoming more popular, safety and reliability of such minimally-invasive procedures remain a concern. Visualization of the technical steps by ultrasound suggests increased safety but shows the potential for harm to tendons, nerves and vessels without proper instrumentation. We present the results of implementing a sonographically guided minimally-invasive procedure in 106 trigger digits of 64 patients between 2018-2021.
METHODS
A guide instrument for use with a commercially available hook knife was developed and tested in 16 cadaver hands. Due to complication early in our clinical series this guide was modified in due course. A revised design of the guide has been in use since November 2019 with improved performance and safety.
RESULTS
One hundred six procedures in 64 patients were performed. After guide revision, we report a success rate of 97.3%. Complications after instrument revision include two cases of incomplete pulley release and one case of inadvertent skin laceration. The majority of patients report returning to all strenuous activities within two weeks at most apart from four individuals with prolonged postoperative discomfort.
CONCLUSION
We present the results of the development and implementation of a novel guide instrument for use with a hook knife to treat trigger finger. Despite several limitations of this study, we show that sonographically controlled, minimally-invasive A1 pulley release can be performed safely and effectively with appropriate surgical instruments and practice.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery 04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery > Hand Surgery |
UniBE Contributor: |
Sutter, Damian, Vögelin, Esther |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1471-2474 |
Publisher: |
BioMed Central |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
14 Nov 2023 09:47 |
Last Modified: |
26 Nov 2023 02:26 |
Publisher DOI: |
10.1186/s12891-023-06982-x |
PubMed ID: |
37950217 |
Uncontrolled Keywords: |
Complications Hand surgery Stenosing tenosynovitis Trigger finger Ultrasonography |
BORIS DOI: |
10.48350/188796 |
URI: |
https://boris.unibe.ch/id/eprint/188796 |
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