Failure rates and analysis of risk factors for percutaneous A1 pulley release of trigger digits

This study aimed to identify the rates and risk factors for failure of percutaneous A1 pulley release. We retrospectively analysed patients who underwent percutaneous A1 pulley release between 2015 and 2019. We defined failure as (1) pain or discomfort at the final follow-up, (2) when open release or revision percutaneous release was performed, or (3) when steroid injections were administered three or more times for symptom control. A total of 331 digits from 251 patients were included. The mean follow-up duration was 47 months (minimum 24 months). Complete resolution was achieved in 287 cases (87%), but 21% required steroid injection before symptoms settled. There was failure in 44 cases (13%). Involvement of the index, middle and ring fingers was significantly different between the successful and failure groups. Percutaneous A1 pulley release has a long-term success rate of 87%. The failure rate was higher when the procedure was performed on the index, middle or ring fingers.