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Trigger Finger Release 26055

 
CPT Coding Technique
Indications Complications
Contraindications Follow-up Care / Rehab Protocol
Alternatives Outcomes
Pre-op Planning / Case Card Review References

synonyms:trigger finger release, trigger thumb release,

 Trigger Finger Release CPT

Trigger Finger Release Indications

  • Trigger finger of thumb that has failed conservative management

 Trigger Finger Release Contraindications

  •  infection

Trigger Finger Release Alternatives

  • Trigger finger injection

Trigger Finger Release Pre-op Planning

Trigger Finger Release Technique

  • Prep and drape in standard sterile fashion.
  • Local anesthetic injected into skin and flexor sheath.
  • Longitudinal incision over A1 pully between the distal transverse palmar crease and the base of the finger flexion crease.
  • Blunt dissection under loop magnification down to A1 pulley. A1 pulley is clearely visualized and NV bundles protected.
  • A1 pulley is sharply released with #15 blade starting proximally just proximal to the base of the finger flexion crease which ensures the A2 pulley is preserved.
  • Tendons are pulled from the sheath and inspected. Full triggerless motion is verified.
  • Irrigation.
  • Close skin

Trigger Thumb Release Technique

  • Prep and drape in standard sterile fashion.
  • Local anesthetic injected into skin and flexor sheath.
  • Radially based V shaped flap incision centered over the thumb A1 pulley ath the MP crease. Ensure thumb MCP joint is in slight flexion during incision to decrease risk of injury to radial digital nerve.
  • Blunt dissection under loop magnification down to A1 pulley. A1 pulley is clearely visualized and NV bundles protected.
  • A1 pulley is sharply released with #15 blade starting proximally just proximal to the base of the finger flexion crease which ensures the A2 pulley is preserved.
  • Tendons are pulled from the sheath and inspected. Full triggerless motion is verified.
  • Irrigation.
  • Close skin

Trigger Finger Release Complications

  • incomplete cure
  • digitial nerve injury
  • A2 pulley release with bowstringing (Heithoff SJ, J Hand Surg 1988;13A:567)
  • stiffness
  • wound maceration
  • vascular injury
  • tendon laceration

 

Trigger Finger Release Follow-up care

  • Post-op:
  • 7-10 Days:
  • 3 Weeks:
  • 6 Weeks:
  • 2 Months:
  • 3 Months:
  • 6 Months:
  • 1Yr:

Trigger Finger Release Outcomes

  • Generally resolves completely after release.

Trigger Finger Release Review References

  1. Fleisch SB, JAAOS 2007;15:166
  2. Saldana MJ, JAAOS 2001;9:246
  3. Pope DF, Wolfe SW: Safety and efficacy of percutaneous trigger finger release.  J Hand Surg Am 1995; 20:280-283.
  4. Bain GI, Turnbull J, Charles MN, Roth JH, Richards RS: Percutaneous A1 pully release: A cadaveric study.  J Hand Surg Am 1995; 20: 781-784.
  5. Lane LB: Commentary: Percutaneous release of the first annular pulley. J Hand Surg Am 1995; 20:785-6.

 

 

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