A Novel Surgical Technique Using a Hockey Stick–Like Guided Knife to Go Through the Eyes of a Needle for Trigger Finger

Abstract

Trigger finger surgery is primarily managed with open surgery accompanied by 10–14 days of postoperative recovery, which may interrupt activities of daily living. In the past, we attempted to perform percutaneous surgery by inserting a hockey stick–shaped guide knife through a scalpel incision several millimeters long. Sometimes, we encounter difficult cases wherein triggering does not disappear despite repeated attempts to release the A1 pulley through the small incision, thus forcing us to extend the incision. As a result, the postoperative recovery is sometimes prolonged. We describe our experience using a novel percutaneous procedure in which a guide knife was inserted through one or two 20-gauge needle holes, instead of a scalpel skin incision, to release the A1 pulley. We describe a new method that minimizes skin and soft tissue damage and reliably shortens posttreatment recovery.

Keywords

• Case report
• Eyes of a needle technique
• Percutaneous surgery
• Special guided knife
• Trigger finger