Ultrasound-guided microinvasive trigger thumb release with an 18-gauge blade-tipped needle: A case series

Ultrasound (US)-guided trigger finger release provides comparable outcomes to open surgical release, yet there is a lingering concern for neurovascular injury specifically in the thumb due to its unique anatomy. This study evaluated the outcomes of patients undergoing US-guided trigger thumb release. A retrospective case series of patients undergoing US-guided trigger thumb release using an 18-gauge blade-tipped needle evaluated outcomes, including resolution of mechanical symptoms, improvement in pain and function, ability to return to daily activities, major or minor complications, and need for revision procedures. Twenty-eight patients (29 cases) with an average age of 59.2 (31-91 years, SD 11.8) met criteria and agreed to participate in the study. Average follow-up time was 3.4 years (1.0-5.9 years, SD 1.2) post-procedure. 100% of the patients reported complete resolution of mechanical symptoms. Average numeric pain rating scale and Nirschl scores were 0.2 (SD 0.5) and 0.1 (SD 0.3), respectively. 100% of patients were able to return to work and 96% were able to return to recreational activities. No major or minor complications (including neurovascular injuries) were reported. No patients required a revision procedure. US-guided trigger thumb release using a blade-tipped needle appears to be a safe and effective procedure when performed by an experienced provider. Further research will be needed to establish its generalizability and characterize comparative outcomes and risk-benefit profiles of this technique compared to open surgical trigger thumb releases.