Francois J Duminy

PLASTIC & RECONSTRUCTIVE SURGEON

 

Trigger Finger Release by Needle

After many needle releases of DuPuytrens Contractures by means of needles, we explored the literature and found that others had already proven that Trigger Fingers could be safely released by similar methods.

Our own practice has been as follows:

  • The Anaesthetist gives light conscious sedation and a single localised local anaesthetic injection is given.
  • No tourniquet is required.
     
  • The patient is asked to move the finger so that the nodule can be felt by the surgeon
     
  • We use a specially modified needle to pass through the skin and tendon sheath, landing the tip on the nodule.
     
  • Now we "ride" the offending nodule smoothly through the pulley. By design, the needle cuts the pulley on its way back (as the patient straightens the finger).
     
  • The finger is then actively flexed and extended by the patient to ensure that the nodule is moving freely through the widened passage. (this is an instant cure!)
     
  • There is no wound to suture. Soft dressings with compression bandages are applied to the hand overnight.
     
  • Pre- and post-operative Physiotherapy is not obligatory.
     
  • The patient is encouraged from the beginning to move the hand through a full range.
     
  • We can do both hands at the same time as essential tasks can be carried out almost immediately.

 

Benefits experienced by most patients:

1. Improved mobility and function of the hand

2. Removal of the triggering

 

Negative Aspects:

1. Pain, swelling and bruising in the first few days requires elevation of the hand

2. Scar, nil

3. Surgical Complications - as for an injection - very low risk of infection, bleeding, haematoma.

4. Trigger finger may recur after a few years