DATE OF PROCEDURE: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS: Bilateral index trigger finger.
POSTOPERATIVE DIAGNOSIS: Bilateral index trigger finger.
PROCEDURE PERFORMED: Release of bilateral index trigger finger.
SURGEON: John Doe, MD
ASSISTANT: None.
ANESTHESIA: Local with sedation.
ESTIMATED BLOOD LOSS: Minimal.
INDICATIONS FOR PROCEDURE: The patient has a history of triggering in both of his index fingers. He has had cortisone injections without improvement and now presents for trigger finger release.
DESCRIPTION OF PROCEDURE: The patient was placed in the supine position on the OR table. After adequate IV sedation, the area of skin overlying the A1 pulley of bilateral index fingers was anesthetized with 0.5% Marcaine. A tourniquet was placed on both forearms over Webril cast padding and then the hand and wrist prepped and draped in a sterile fashion. Each side was done individually starting with the left side.
The hand was exsanguinated and tourniquet inflated to 275 mmHg. A 1 cm incision was made in line with the palmar flexion crease over the A1 pulley of the left index finger. The incision was taken down through the subcutaneous tissue and blunt dissection took us to the A1 pulley. This was divided sharply using the scalpel, also some of the palmar aponeurosis was also released. The tendon itself did not show any significant abnormality to it, and the patient was able to demonstrate active flexion and extension at the end of the procedure. The wound was irrigated out well and tourniquet released. Hemostasis was obtained. The wound was closed with interrupted 5-0 nylon. Adaptic, dry sterile dressing was applied.
The exact same procedure was performed for the right side. The tendon also on the right side did not show any significant degenerative changes, but otherwise, everything was done as stated on the left and it was also dressed with Adaptic, dry sterile dressing. The patient tolerated the procedure well and was transferred to the recovery room in satisfactory condition.
