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The purpose of this study was to evaluate the safety and efficiency of transdermal anaesthesia using eutectic mixture of lidocaine and prilocaine (EMLA) in patients undergoing percutaneous trigger finger release and to compare it with lidocaine infiltration.

In this prospective, randomised study percutaneous release of the A1 annular pulley was performed to treat stenosing tenosynovitis (trigger finger syndrome) in 50 patients (50 fingers). The procedure was performed either under transdermal anaesthesia using EMLA applied transcutaneously 120 minutes prior to the operation (Group A, n = 25) or using local infiltration anaesthesia using lidocaine (Group B, n = 25). Pain experienced during administration of anaesthesia and during the operation was assessed using a 10-point Visual Analogue Pain Scale (VAPS), while all patients rated the effectiveness of anaesthesia with a 5-point scale.

There were no significant differences between the two groups in the VAPS during the operation (1.33 ± 0.52 versus 1.59 ± 0.87) and the satisfaction scores (4.6 ± 0.2 versus 4.4 ± 0.3). The VAPS score during the administration of anaesthesia was statistically significantly less in the EMLA group (0 versus 5.96 ± 2.41). All patients were satisfied with the final result of the operation.

Percutaneous trigger finger release can be performed as an office procedure with the use of EMLA avoiding the use of injectable local infiltration anaesthesia.

Background: Primary treatment of trigger digits is conservative including stretching, night splinting and combination of heat and ice. When these methods fail, invasive methods such as corticosteroid injection, percutaneous release and open surgery are used. The purpose of this study is to compare the efficacy of two outpatient methods of percutaneous trigger finger release (PTFR) and corticosteroid injection (CI).

Methods: This study is a randomized clinical trial that was performed with 6-month follow up. A total of 83 patients with trigger finger treated either with corticosteroid injection (n:40) or percutaneous release of the A1 pulley (n:43) were enrolled in this study. Demographic data were recorded before intervention. Pain score (VAS criterion), disease stage (Quinnell criteria), patient satisfaction and complications such as paresthesia, scarring, and stiffness (decrease in the range of motion) were recorded after the intervention. We used SPSS program (statistical package for the social science SPSS version 16) to perform the analysis.

Results: There were 18 male (21.7%) and 65 female (78.3%) patients, whose mean age was 52.54 ± 11.45 (28–85) years. There was a significant difference between the degree of pain at the time of the third, sixth weeks and sixth months in two groups. The degree of pain was lower in the CI group in the third and sixth weeks but it was lower in the PTFR group in the sixth month. Satisfaction of the patients in the sixth month was significantly higher in the PTFR group. The incidence of stiffness was also significantly lower in the PTFR group in the sixth month.

Conclusions: Patients in PTFR group had greater recovery and satisfaction level and lower recurrence rate and pain. Therefore PTFR may be used as a substitute for CI in the treatment of trigger finger from the beginning especially in patients who do not want to have open surgery.

Background: The aim of this randomised prospective study is to compare the outcomes of traditional open trigger digit release versus ultrasound-guided modified small needle-knife (SNK) percutaneous release in the treatment of trigger digits.

Methods: Patients with grade 2 and above trigger digits were enrolled into the study and randomly assigned to traditional open surgery (OS) or ultrasound-guided modified SNK percutaneous release group. The patients were followed up for 7, 30 and 180 days after treatment and data with regard to visual analogue scale (VAS) score and Quinnell grading (QG) was collected and compared between the two groups.

Results: A total of 72 patients were enrolled in the study with 30 in the OS group and 42 in the SNK group. VAS scores and QG of the two groups significantly decreased at 7 days and 30 days after treatment compared to before treatment, but there was no significant difference between the two groups. There was also no differences between the two groups at 180 days and between the values at 30 days and 180 days.

Conclusions: The outcomes of ultrasound-guided SNK percutaneous release is similar to traditional OS.

Level of Evidence: Level II (Therapeutic)