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Ultrasound‐Guided First Annular Pulley Injection for Trigger Finger
Author(s) -
Bodor Marko,
Flossman Tiffany
Publication year - 2009
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2009.28.6.737
Subject(s) - medicine , trigger finger , lidocaine , triamcinolone acetonide , ultrasound , surgery , radiology , alternative medicine , pathology
Objective. The purpose of this study was to develop an ultrasound‐guided first annular (A1) pulley injection technique for trigger finger with documentation of outcomes at 1 year. Methods. We performed a short‐axis injection into a triangle bordered by the A1 pulley, the flexor digitorum superficialis and profundus tendons and volar plate, and the distal metacarpal bone with a 10‐mg median dose of triamcinolone acetonide and 2% lidocaine. This was a prospective study of 50 of 52 consecutive trigger fingers from 24 patients recruited from a physical medicine and rehabilitation private practice. Results. All patients were available for follow‐up, with 94% (47 of 50) of fingers having complete resolution of symptoms at 6 months, 90% (37 of 41) at 1 year, 65% (17 of 26) at 18 months, and 71% (12 of 17) at 3 years after a single injection. Conclusions. Our ultrasound‐guided A1 pulley injection technique is a highly effective and minimally invasive treatment option for trigger finger with a 90% success rate at 1 year for complete resolution of symptoms after a single injection. Assuming similar patient populations, our results were statistically significant ( P < .01) compared with the 56% to 57% success rates recently reported for blind injections.