Effectiveness of Percutaneous A1 Pulley Release Under Ultrasound Guidance Associated With Infiltration, Versus Infiltration Alone, in Patients With Trigger Finders Who Have Failed a First Infiltration: a Randomized Controlled Trial
Trigger finger is a mechanical problem characterized by pain and catching of digit in flexion. Histological changes of A1 pulley and synovial proliferation have been identified as factors that prompt trigger finger The first-line treatment of trigger finger is conservative with splinting and corticosteroid injection. If the first infiltration fails, either a second infiltration or surgical sectioning of the pulley is proposed. Surgery can be performed by several techniques (open section, percutaneous section with palpatory guidance, or under ultrasound guidance). Percutaneous A1 pulley release under ultrasound guidance consists of cutting the A1 pulley by a percutaneous insertion with small needle under local anaesthesia. The hypothesis of the study is that percutaneous A1 pulley release under ultrasound guidance followed by a corticosteroid injection would be more effective than a second corticosteroid injection alone on complete resolution of the trigger finger symptoms
• Patient ≥ 18 years old,
• Presence of a trigger finger (thumb or long fingers) to be treated
• Quinnell score \>1
• Episode of trigger characterized on questioning or clinical examination
• Failure of a first corticosteroid infiltration \> 3 months before inclusion
• First infiltration within 15 months of inclusion
• Thickening A1 pulley on ultrasound ≥ 0.5 mm
• Patient who has the capacity to understand the protocol and has given consent to participate in the research,
• Patient with social security coverage