• Marko Bodor and Tiffany Flossman.
• Queen of the Valley Medical Center, 3421 Villa Ln, Suite 2B, Napa, CA 94558, USA. mbodormd@sbcglobal.net
• J Ultrasound Med. 2009 Jun 1;28(6):737-43.

ObjectiveThe purpose of this study was to develop an ultrasound-guided first annular (A1) pulley injection technique for trigger finger with documentation of outcomes at 1 year.MethodsWe performed a short-axis injection into a triangle bordered by the A1 pulley, the flexor digitorum superficialis and profundus tendons and volar plate, and the distal metacarpal bone with a 10-mg median dose of triamcinolone acetonide and 2% lidocaine. This was a prospective study of 50 of 52 consecutive trigger fingers from 24 patients recruited from a physical medicine and rehabilitation private practice.ResultsAll patients were available for follow-up, with 94% (47 of 50) of fingers having complete resolution of symptoms at 6 months, 90% (37 of 41) at 1 year, 65% (17 of 26) at 18 months, and 71% (12 of 17) at 3 years after a single injection.ConclusionsOur ultrasound-guided A1 pulley injection technique is a highly effective and minimally invasive treatment option for trigger finger with a 90% success rate at 1 year for complete resolution of symptoms after a single injection. Assuming similar patient populations, our results were statistically significant (P < .01) compared with the 56% to 57% success rates recently reported for blind injections.

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