Percutaneous Trigger Finger Release: A Comparison of a New Push Knife and a 19-Gauge Needle in a Cadaveric Model

An instrument was developed for percutaneous release of the A1 pulley and this procedure was compared with percutaneous release using a 19-gauge needle in 20 fresh-frozen cadaver hands. This instrument was developed to avoid the complications of incomplete release and flexor tendon damage previously reported with percutaneous release using a 19-gauge needle. Seventy-eight fingers were used in the study. The push knife was used to release 52 fingers. The A1 pulley was completely released in 51 fingers (98%) and there were no incidents of flexor tendon damage. A 19-gauge needle was used to release 26 fingers. The A1 pulley was completely released in only 10 fingers (38%) and the flexor tendon was damaged in 19 (73%). In cadaveric hands, this instrument proved to be more effective at creating a complete release of the A1 pulley and demonstrated less disruption of the flexor tendon surface compared with current needle techniques.