Sonographically assisted minimally invasive release (interventional microadhesiolysis) of the A1 pulley to treat trigger digit

Ahn, Kang; Jhun, Hyung Joon; Lee, Sang Chul; Lee, Young Jin; Kim, Eun Ha; Lim, Tae Kyun; Oh, Se Yeon

Clinical Research

General Article

Anesthesia and Pain Medicine 2009;4(2):100-105.
Published online April 30, 2009.

Sonographically assisted minimally invasive release (interventional microadhesiolysis) of the A1 pulley to treat trigger digit

Kang Ahn, Hyung Joon Jhun, Sang Chul Lee, Young Jin Lee, Eun Ha Kim, Tae Kyun Lim, Se Yeon Oh

¹Chronic Pain Management Center, Cha Biomedical Center, Kangnam Cha Hospital, Cha University, Seoul, Korea.
²Musculoskeletal Clinic, Department of Occupational and Environmental Medicine, College of Medicine, Korea University, Korea. occenvned@yahoo.co.kr
³Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, Korea.

Abstract

BACKGROUND
We developed a sonographically assisted minimally invasive release technique (entitled as interventional microadhesiolysis) of the A1 pulley to treat trigger digit. This paper introduces the procedure and evaluates the efficacy of the intervention for trigger digit.
METHODS
Eleven trigger digits in nine patients were treated with a specially designed needle using ultrasonographic assistance. The technique includes subcutaneous and intrasheath release. Subcutaneous release was performed by obliquely inserting the needle into the interdigital space and advancing it to release the subcutaneous tissue overlying the affected area. If the A1 pulley was not completely released, intrasheath release was performed by advancing the needle into the flexor tendon sheath, and the operator fixed the needle while the digit was passively flexed and extended.
RESULTS
After the patients underwent the technique, all of the patients reported a reduction in pain and improved range of motion.
CONCLUSIONS
This study suggests that interventional microadhesiolysis is an effective treatment for trigger digit.

Key Words: intervention, trigger digit, ultrasonography