PERCUTANEOUS A1 PULLEY RELEASE - A CADAVERIC STUDY

Percutaneous A1 pulley release was performed on 17 fresh-frozen cadave ric hands with a 14-gauge angiocath needle. Each hand was then explore d to assess the adequacy of release and the degree of injury to adjace nt structures. Complete release of the Al pulley was obtained in 45 of the 66 fingers and in 10 of the 17 thumbs. Significant injury to the flexor tendons was observed in two digits. All tendon injuries occurre d along the line of the fibers. There were no digital nerve injuries. The release was within 2 mm of a thumb digital nerve in seven hands an d the little finger ulnar digital nerve in two. In the thumb, the clos e proximity of the digital nerves makes percutaneous trigger digit rel ease potentially hazardous. With the little finger held in abduction t he risk of digital nerve injury or inadequate release is reduced. Perc utaneous trigger finger release ran be safely performed in the index, long, and ring fingers.