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Carpal Tunnel Syndrome and Trigger Finger�� Diagnosis & Treatment Patient Education Seminar

August 26th, 2025

Alamo Women’s Club

Dr. Orrin Franko

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Carpal Tunnel Syndrome

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You Are Not Alone

Carpal tunnel syndrome is a common condition that affects more than 13 million people in the U.S.

Papanicolaou GD, et al. The prevalence and characteristics of nerve compression syndromes in the general population. J Hand Surg 2001;26A:460-6.

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Carpal Tunnel Prevalence

Carpal Tunnel Syndrome Fact Sheet. National Institute of Neurological Disorders and Stroke, National Institutes of Health. Carpal Tunnel Syndrome Fact Sheet. Accessed November 2019.

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Symptoms of Carpal Tunnel Syndrome (CTS)

  • CTS predominantly affects the thumb, index and middle fingers
    • Loss of strength & dropping items
    • Sensation of pins and needles in the hand
    • Forearm tenderness
    • Pain up the arm
    • Weak grip strength
    • Pain during the night / waking up from sleep

C Burton, et. Al. Diagnosing and managing carpal tunnel syndrome in primary care. Br J Gen Pract. 2014 May; 64(622): 262–263. doi: 10.3399/bjgp14X679903

Carpal Tunnel Syndrome Fact Sheet. National Institute of Neurological Disorders and Stroke, National Institutes of Health. Carpal Tunnel Syndrome Fact Sheet. Accessed November 2019.

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Carpal Tunnel Syndrome

Tingling - Numbness - Pain

Together, these symptoms make everyday tasks very challenging or nearly impossible.

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What Causes Carpal Tunnel Syndrome?

  • Repetitive maneuvers
  • Obesity
  • Pregnancy
  • Arthritis (esp: inflammatory arthritis)
  • Hypothyroidism
  • Diabetes
  • Trauma
  • No cause / unknown

American Association of Hand Surgery. Carpal Tunnel Syndrome FAQ. https://handsurgery.org/public. Accessed November 2019.

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Carpal Tunnel Syndrome

  • The median nerve becomes compressed as it travels through the carpal tunnel in the wrist

Carpal Bones

Tendons

Transverse Carpal Ligament

Median Nerve

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Diagnosing Carpal Tunnel Syndrome

  • Symptom history
  • Quality of Life questionnaire
  • Range of motion
  • Tinel’s sign
  • Phalen’s test
  • Grip strength
  • EMG
  • Ultrasound

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Treatment Options

  • Behavioral modifications
  • Stretching
  • Bracing
  • OTC anti-inflammatories
  • Steroid injections
  • Carpal tunnel release with ultrasound guidance
  • Endoscopic carpal tunnel release
  • Open carpal tunnel release

American Society for Surgery of the Hand. Carpal Tunnel Syndrome. https://handcare.assh.org/Anatomy/Details-Page/ArticleID/27950/Carpal-Tunnel-Syndrome. Accessed November 2019.

Less Invasive

More Invasive

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Carpal Tunnel Release with Ultrasound Guidance

  • Using UltraGuideCTR™ and real-time ultrasound guidance, this procedure can be performed in a matter of minutes

Joseph AE, et al. Clinical results of ultrasound guided carpal tunnel release performed by a primary care sports medicine physician. J Ultrasound Medicine. August 2019. https://doi.org/10.1002/jum.15120

Transection of the transverse carpal ligament

A small incision

Relieves pressure on median nerve

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Simple, elegant, safe and effective�carpal tunnel release with real-time ultrasound guidance offers�rapid recovery and an excellent patient experience

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Carpal Tunnel Release with UltraGuideCTR and Real-Time�Ultrasound Guidance

CTR with UltraGuideCTR�and real-time�ultrasound guidance

Previous mini-open CTR surgery

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CTR with UltraGuideCTR and Real-Time Ultrasound Guidance

Henning PT, Yang L, Awan T, et al. Minimally invasive ultrasound-guided carpal tunnel release: preliminary clinical results. J Ultrasound Med. 2018 Nov;37(11):2699-2706.

Joseph AE, et al. Clinical results of ultrasound guided carpal tunnel release performed by a primary care sports medicine physician. J Ultrasound Medicine. August 2019. https://doi.org/10.1002/jum.15120

Procedure room or�office setting

Local anesthesia

Small wrist incision typically closed without sutures

Reduce or eliminate need for opioids

Return to normal activity in days not months

Opportunity for fewer follow �up appointments

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UltraGuideCTR Patient Reported Experiences

APEX-CTR Database (Assessment of the Patient Experience – Carpal Tunnel Release). A prospective database measuring short-term and long-term patient experience after carpal tunnel release surgery. APEX Data Report 4/19/2022. Data on file.

Numbers above reflect Median values.

Return to Work�1.0 Days

Patient Satisfaction �5.0�(Scale 1-5, 5=very satisfied)

Intraoperative Pain�1.0�(Scale 0-10, 0=no pain)

Return to Normal Daily Activity�1.0 Days

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What to Expect

  • Performed in an outpatient surgery center (@ EBHMC, this is typically office-based)
  • Oral meds and/or local anesthesia pre-procedure
  • No sutures necessary
  • Rapid return to normal activities

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Patient Testimonials

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www.BayAreaCarpalTunnel.com

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Next Steps

  • Stay after this seminar and we will scan your wrist to measure your median nerve to determine if you should schedule an office consult

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  • Our scheduling team is here tonight; feel free to make an appointment with them before leaving

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Thank you!

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Thank You

Refer to the device instructions for use for detailed information regarding the procedure, indications, contraindications, warnings, precautions, and potential complications/adverse events. There are potential risks associated with the Sonex Health UltraGuideCTR. It may not be appropriate for all patients and not all patients may benefit. Talk to your doctor about the benefits and risks and whether carpal tunnel release with UltraGuideCTR is right for you. For more information about the risks, visit: SonexHealth.com

 

Rx Only.

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UltraGuideCTR is a registered trademark of Sonex Health, Inc. All other trademarks are the property of their respective owners.

© 2022 Sonex Health, Inc. All rights reserved.

​

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Trigger Finger

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You are Not Alone

Trigger finger is a common condition that affects approximately 9 million people in the U.S.

Strom et al: Trigger Finger in Diabetes. J Med Sco NJ 1977;74:951-4.

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Who Gets Trigger Finger?

  • People who have jobs or hobbies that require strenuous repetitive motions

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  • People between the ages of 40 and 60

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  • People who have osteoarthritis, rheumatoid arthritis or diabetes

Trigger Finger or Trigger Thumb. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/7080-trigger-finger--trigger-thumb. Accessed June 8, 2022.

Photos courtesy of https://www.pexels.com/

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What Causes Trigger Finger?

Trigger Finger. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/trigger-finger/symptoms-causes/syc-20365100. Accessed June 13, 2022.

Finger unable to smoothly bend and straighten

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Tendon sheath surrounding finger’s tendon becomes�inflamed or irritated​​

Inflammation affects normal gliding motion of tendon sheath

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Symptoms of Trigger Finger May Affect One or More Fingers

  • Pain at the base of the affected finger, where the finger joins with the palm

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  • Swelling within the affected tendon or development of a cyst

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  • Stiffness or loss of motion, difficulty in bending the finger

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  • Mechanical symptoms: popping, catching or locking

Trigger Finger or Trigger Thumb. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/7080-trigger-finger--trigger-thumb. Accessed June 8, 2022.

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Diagnosing Trigger Finger

  • Symptom history

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  • Quality of Life questionnaire

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  • Range of motion

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  • Quinnell grading system

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Treatment Options

  • Behavioral modifications
  • Stretching
  • Splinting
  • OTC anti-inflammatories
  • Steroid injections
  • Trigger finger release with ultrasound guidance
  • Open trigger finger release

Less Invasive

More Invasive

Trigger Finger. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/trigger-finger/. Accessed June 13, 2022.

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Trigger Finger Release with Ultrasound Guidance

Using UltraGuideTFR™ and real-time ultrasound guidance, trigger finger release can be performed in a matter of minutes

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Transection of the A1 pulley

A small �(3-4mm) incision

Allows smooth movement of flexor tendon

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Simple, safe and effective trigger finger release with real-time ultrasound guidance: rapid recovery and an excellent patient experience

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Trigger Finger Release with UltraGuideTFR and Real-Time Ultrasound Guidance

Post TFR procedure incision with UltraGuideTFR and real-time ultrasound guidance

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TFR with UltraGuideTFR and Real-time Ultrasound Guidance

APEX-TFR Database (Assessment of the Patient Experience – Trigger Finger Release). A prospective database measuring short-term and long-term patient experience after trigger finger release surgery. APEX Data Report 6/15/2022. Data on file.

Local anesthesia

Small hand incision typically closed without sutures 

Reduce or eliminate need �for opioids

Return to normal activity in �days not weeks

Opportunity for fewer follow-up appointments

Procedure room or�office setting

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UltraGuideTFR Patient Reported Experiences

APEX-TFR Database (Assessment of the Patient Experience – Trigger Finger Release). A prospective database measuring short-term and long-term patient experience after trigger finger release surgery. APEX Data Report 6/15/2022. Data on file.

Numbers above reflect Median values.

Return to Work�1.0 Days

Patient Satisfaction �5.0�(Scale 1-5, 5=very satisfied)

Intraoperative Pain�1.0�(Scale 0-10, 0=no pain)

Return to Normal Daily Activity�1.0 Days

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What to Expect

  • Performed in an outpatient procedure room
  • Oral meds and/or local anesthesia pre-procedure
  • No sutures necessary
  • Rapid return to normal activities

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Patient Testimonial

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