# Ultrasound-Guided Percutaneous Tenotomy for Trigger Finger: A Minimally Invasive Office-Based Case

## TL;DR

This case study shows that ultrasound-guided percutaneous tenotomy is a safe and effective office-based treatment for trigger finger when other methods fail.

## Contribution

The study presents a novel application of ultrasound guidance for A1 pulley fenestration in treating trigger finger.

## Key findings

- Ultrasound-guided A1 pulley fenestration resolved symptoms in a patient with partial response to corticosteroid injections.
- The procedure was completed in an office setting with full recovery within two weeks.
- The intervention demonstrated safety and effectiveness for refractory trigger finger cases.

## Abstract

Trigger finger is frequently managed with conservative therapy and corticosteroid injections, while surgery is reserved for refractory cases. Ultrasound-guided percutaneous tenotomy has emerged as a minimally invasive alternative that allows direct visualization of the A1 pulley, flexor tendons, and surrounding neurovascular structures. We present the case of a 70-year-old man with Grade 3 stenosing tenosynovitis of the left middle finger and Grade 2 involvement of the left index finger who experienced only partial improvement after a landmark-based corticosteroid injection. He subsequently underwent ultrasound-guided A1 pulley fenestration with corticosteroid injection in both digits, resulting in complete resolution of pain, triggering, and functional limitation within two weeks. This case demonstrates the safety, efficiency, and clinical effectiveness of ultrasound-guided A1 pulley tenotomy as a quick, office-based intervention for patients who do not achieve full relief from conservative measures.