Follow-up investigation of open trigger digit release
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The purpose of this retrospective study was to identify the postoperative complications and disorders associated with open trigger finger release. Factors that were investigated by this study included demographic details, the number of digits affected, BMI, level of manual strain, trauma, received systemic medication, hand dominance, pre-treatment with steroid injection, and concomitant diseases.
One hundred and three patients, who underwent open release surgery for 117 trigger fingers and thumbs, were followed up until complete resolution of all complaints. Patients’ age, BMI, hand dominance, occupational manual strain, and previous medical history regarding trigger finger or thumb were obtained. Associated conditions and medical treatment, trauma, and previous hand surgical interventions were included as well. Details regarding duration of complaints, ROM, visual analogue pain scale, swelling, recurrence of the disease following previous surgical release, and persistence of complaints following corticosteroid injection were examined.
The dominant hand was not significantly more frequently affected than the non-dominant hand. Occupation also did not influence the incidence of trigger digit. Patients with systemic steroid therapy had a significantly shorter duration of postoperative symptoms with a mean duration of 29.3 days (range, 28–31 days ± 1.3). Significantly less postoperative swelling was noticed in patients with a pre-surgical steroid injection. The mean duration of symptoms before and after surgery was significantly shorter for a trigger thumb than for trigger finger.
Open trigger digit release constitutes an adequate low-risk surgical procedure for treatment of trigger digit. In this study, we could show that the incidence of this disease is not significantly correlated with the manual strain, trauma, BMI, hand dominance or concomitant diseases like diabetes mellitus, rheumatoid arthritis, renal insufficiency, and hypothyroidism. Additionally, this study illustrates the importance of a careful postoperative follow-up treatment to avoid potential persistent functional limitations.
KeywordsConcomitant diseases Hand dominance ROM Steroid therapy Trigger finger
- 1.Fahey JJ, Bollinger JA (1954) Trigger-finger in adults and children. J Bone Joint Surg 36A:1200–1218Google Scholar
- 4.Sampson SP, Badalamente MA, Hurst LC, Seidmann J (1991) Pathobiology of the human A1 pulley in trigger finger. J Hand Surg 16A:714–721Google Scholar
- 5.Sbernardori MC, Bandiera P (2007) Histopathology of the A1 pulley in adult trigger fingers. J Hand Surg 32E:556–559Google Scholar
- 8.Ryzewicz M, Wolf J (2006) Trigger digits: principles, management, and complications. J Hand Surg 31A:135–146Google Scholar
- 9.McAuliffe JA (2010) Tendon disorders of the hand and wrist. J Hand Surg 35A:846–853Google Scholar
- 10.Fitzgibbons PG, Weiss AP (2008) Hand manifestations of diabetes mellitus. J Hand Surg 33A:771–775Google Scholar
- 11.Blyth MJ, Ross DJ (1996) Diabetes and trigger finger. J Hand Surg 21B:244–245Google Scholar
- 12.Chammas M, Bousquet P, Renard E, Poirier JL, Jaffiol C, Allieu Y (1995) Dupuytren’s disease, carpal tunnel syndrome, trigger finger, and diabetes mellitus. J Hand Surg 20A:109–114Google Scholar
- 13.Drossos K, Remmelink M, Nagy N, de Maertelaer V, Pasteels JL, Schuind F (2009) Correlations between clinical presentations of adult trigger digits and histologic aspects of the A1 pulley. J Hand Surg 34A:1429–1435Google Scholar
- 14.Newport ML, Lane LB, Stuchin SA (1990) Treatment of trigger finger by steroid injection. J Hand Surg 15A:748–750Google Scholar
- 19.Freiberg A, Mulholland RS, Levine R (1989) Nonoperative treatment of trigger finger and thumb. J Hand Surg 14A:553–558Google Scholar
- 20.De la Parra-Márquez ML, Tamez-Cavazos R, Zertuche-Cedillo L, Martinez-Pérez JJ, Velasco-Rodriguez V, Cisneros-Pérez V (2008) Risk factors associated with trigger finger. Case–control study. Cir Cir 76:323–327Google Scholar
- 24.Thorpe AP (1988) Results of surgery for trigger finger. J Hand Surg 13B:199–201Google Scholar
- 25.Turowski GA, Zdankiewicz PD, Thomson JG (1997) The results of surgical treatment of trigger finger. J Hand Surg 22A:145–149Google Scholar
- 26.Will R, Lubahn J (2010) Complications of open trigger finger release. J Hand Surg 35A:594–596Google Scholar
- 28.Patterson RW, Li Z, Smith BP, Smith TL, Koman LA (2011) Complex regional pain syndrome of the upper extremity. J Hand Surg 36A:1553–1562Google Scholar
- 29.Bonnici AV, Spencer JD (1988) A survey of trigger finger in adults. J Hand Surg 13B:202–203Google Scholar
- 30.Lim MH, Lim KK, Rasheed MZ, Narayanan S, Beng-Hoi-Tan A (2007) Outcome of open trigger digit release. J Hand Surg 32 E(4):457–459Google Scholar
- 33.Trezies AJ, Lyons AR, Fielding K, Davis TR (1998) Is occupation an aetiological factor in the development of trigger finger? J Hand Surg 23B:539–540Google Scholar
- 34.Vranceanu AM, Jupiter JB, Mudgal CS, Ring D (2010) Predictors of pain intensity and disability after minor hand surgery. J Hand Surg 35A:956–960Google Scholar
- 35.Koh S, Nakamura S, Hattori T, Hirata H (2010) Trigger digits in diabetes: their incidence and characteristics. J Hand Surg 35E(4):302–305Google Scholar
- 38.Jenkins PJ, Watts AC, Duckworth AD, McEachan JE (2011) Socioeconomic deprivation and the epidemiology of carpal tunnel syndrome. J Hand Surg Eur (Epub ahead of print)Google Scholar
- 40.Calleja H, Tanchuling A, Alagar D, Tapia C, Macalalad A (2010) Anatomic outcome of percutaneous release among patients with trigger finger. J Hand Surg 35A:1671–1674Google Scholar