The Upper Hand: Chuck & Chris Talk Hand Surgery Guyons Canal Decompression: Indications and Technique
17 snips
Nov 23, 2025 AI Snips
Chapters
Transcript
Episode notes
Stepwise Treatment For Trigger Finger
- Offer steroid injection first and reserve surgery when injections fail or patient prefers surgery.
- Limit injections to two; consider surgery after repeated recurrences rather than endless injections.
Efficient Technique For A1 Pulley Release
- Use a longitudinal incision, spread purposefully along the tendon, start cut with a knife then finish with scissors for A1 pulley release.
- Visualize full release with active flexion/extension and avoid excessive A2 release; confirm no catching in the OR.
Preop Counseling Changes Expectations
- Counsel patients preoperatively about realistic outcomes, especially persistent PIP contracture and scar risks.
- Document discussions in the chart so patients understand triggering relief may not restore long-standing PIP flexion.