# A Novel Surgical Technique Using a Hockey Stick–Like Guided Knife to Go Through the Eyes of a Needle for Trigger Finger

## TL;DR

A new minimally invasive surgical technique for trigger finger uses a hockey stick-shaped knife through needle holes, reducing recovery time.

## Contribution

A novel percutaneous surgical method using needle holes instead of a scalpel incision to release the A1 pulley in trigger finger.

## Key findings

- The hockey stick-shaped guide knife can be inserted through 20-gauge needle holes to release the A1 pulley.
- This method minimizes skin and soft tissue damage and reliably shortens posttreatment recovery.
- The technique avoids the need for extending incisions in difficult cases.

## Abstract

Trigger finger surgery is primarily managed with open surgery accompanied by 10–14 days of postoperative recovery, which may interrupt activities of daily living. In the past, we attempted to perform percutaneous surgery by inserting a hockey stick–shaped guide knife through a scalpel incision several millimeters long. Sometimes, we encounter difficult cases wherein triggering does not disappear despite repeated attempts to release the A1 pulley through the small incision, thus forcing us to extend the incision. As a result, the postoperative recovery is sometimes prolonged. We describe our experience using a novel percutaneous procedure in which a guide knife was inserted through one or two 20-gauge needle holes, instead of a scalpel skin incision, to release the A1 pulley. We describe a new method that minimizes skin and soft tissue damage and reliably shortens posttreatment recovery.