Percutaneous A1 Pulley Release: Faster Relief for Trigger Finger

In treating trigger finger, percutaneous A1 pulley release is a commonly considered option alongside corticosteroid injection. In a randomized comparison of percutaneous release versus steroid injection, recurrence was lower with percutaneous release and hand function scores improved more over follow-up, supporting its use in select patients. For patients prioritizing fewer repeat visits and better grip without catching, these hand-specific outcomes can guide the choice in the clinic.

Patients with persistent triggering after a period of splinting or activity modification — and sometimes after a first steroid injection — may benefit from percutaneous release, while others may prefer or respond to another injection. Typical risks of percutaneous release include digital nerve irritation or injury, bleeding, infection, and persistent or recurrent triggering, which should be discussed during shared decision‑making.

In many clinics, this minimally invasive procedure is performed under local anesthesia through a small stab incision or needle technique to divide the A1 pulley while protecting nearby neurovascular structures. The goal is straightforward — smooth tendon glide without catching — and the setting often allows same‑day return to light use with a brief period of activity modification.

Moving earlier to percutaneous release after an initial injection fails may lower recurrence and reduce repeated visits, aligning with outpatient workflows and the goal of steady grip without catching.