Percutaneous pulley release

Duration of examination

Approximately 15 minutes plus post-procedure care.

Please bring with you:

• Your request form
• Medicare and any
• Healthcare cards

Payment on the day of the examination is requested.

What is percutaneous pulley release?

Percutaneous pulley release is a treatment for ​‘trigger finger’ — a condition where the finger gets stuck in a flexed position on the palm.

Percutaneous pulley release involves using ultrasound guidance and a needle to cut a band supporting the tendon of the finger. This band is called a pulley.

In many cases of trigger finger it is the so called ​‘A1 pulley’ that is responsible for triggering. The pulley becomes thickened and grips the tendon, causing triggering. This pulley can be released without significantly affecting the function of the finger.

It would be up to your referring doctor to decide if this treatment is best for you.

The procedure is usually performed in instances that have not responded to conservative measures such as corticosteroid injections. It is an alternative to open surgery. However, while percutaneous pulley release is usually successful, some patients may still ultimately require surgery to treat their trigger finger.

What will happen during the examination?

The procedure takes around 15 minutes and is performed under local anaesthesia with no sedation.

The procedure is well tolerated. A sterile technique with real time ultrasound guidance is used.

There are no stitches and only a small hole in the skin at needle entry site is required.

Please be aware that someone should be available to drive you home afterwards.

Are there any risks?

The most common risks are some pain and swelling, post procedure. As with any procedure, infection and bleeding may also be a possible risk.

There have been reports of nerve, artery and tendon injury with the procedure, however, this is unlikely. In the rare event of these complications occurring, a surgical opinion may be required.

In some patients, inflammation of the tendon and sheath (tenosynovitis) can co-exist with triggering and may persist post procedure causing continuation of symptoms.

After the examination

After the procedure swelling and pain can be expected. This should subside over a week or two, but if it persists, please contact your referring doctor or Benson Radiology.

Signs of infection include increasing pain, marked swelling, redness and pus from the needle entry site.

Benson Radiology will phone you around one week post procedure to monitor your progress. Full benefit from the procedure may take a few weeks or more.

Consultation with a hand therapist is recommended post procedure.

Pain can be treated with oral paracetamol or other over the counter pain medications that are safe for you to take (check with your pharmacist or product information sheets).

Keeping the hand elevated on a pillow while seated can also help to relieve pain and swelling. Ice packs may also be used.

We recommend no heavy use of the finger in the first week. Normal daily activity is fine as tolerated. Your hand therapist will be able to provide further instructions.

It is important you understand why and how we will be assisting you. If you have any questions, please call one of our clinics or speak to our staff on the day of your visit.