Published: 2019-10-22

Percutaneous trigger thumb release: a safe push-pull technique

Saravanan G., Thiyagarajan U., Senthil L., Pradeep J. P., Gokul Raj D.


Background: Stenosing tenosynovitis of the thumb is an inflammation of flexor tendon sheath of A1 pulley. Percutaneous release has recently gained popularity. Successful percutaneous release depends upon proper prediction of the location of the A1 pulley and circumventing injury to the neurovascular bundles. The aim of this study was to determine the safety of percutaneous release of trigger thumb.

Methods: Twenty eight patients were included in the study between 2015 and 2018. All the patients were percutaneously released using push-pull technique. Steroid injection was given following the release. Quinnell grading, patient questionnaire and visual analogue scale score was used to assess the patients at 2 weeks, 6 weeks and 6 months and 1 year.

Results: Satisfactory results were found in 93% of patients. Two patients complained of pain and swelling till third week. No digital nerve injury occurred in any patients.

Conclusions: Percutaneous trigger thumb release using this push-pull technique is a simple and a safe technique with very minimal complications. 


Stenosing tenosynovitis, Percutaneous release, Neurovascular injury, Push-pull technique

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