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Association of trigger finger release with extracorporeal constriction: a retrospective review of operated cases

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Abstract

Background

None of the commonly cited risk factors for chronic hand conditions such as trigger finger (TF) delivers a convincing explanation for the striking differences among affected fingers or gender predominance. Hence, we aimed to investigate further possible TF-associated risk factors such as extrinsic mechanical constrictions caused by wedding rings.

Methods

A retrospective data analysis was conducted at a single centre. Patients operated on for release of the A1 pulley from 2005 to 2019 were included. Exclusion criteria involved multiple TF and unknown marital statuses. Case attribution of patients was made with surgical A1-pulley release of the ring finger vs. controls (all other affected single fingers) with marital status equal to “married” as a risk factor. Differences in frequencies were tested using Fisher’s exact test and risk factors expressed as odds ratios (OR). Models adjusting for age were analysed by logistic regression.

Results

In our 188-patient cohort (60 male/128 female), the three most affected (92% of cases) were the thumb (n = 69), ring (n = 52), and middle finger (n = 52). When comparing the affected ring fingers to all other digits collectively, we found a significantly higher number of ring fingers in the married group (OR = 3.0, 95% CI: 1.37–6.7 p = 0.005). Although marital status depended strongly on age, the odds ratio remained almost unchanged after adjusting for age.

Conclusions

We conclude that any form of extrinsic mechanical constriction of fingers associated with rings increases the risk for developing one of the most common hand conditions worldwide; this may be relevant for reassessing disease-related risk.

Level of evidence: Level IV, risk/prognostic.

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Fig. 1

Adapted from https://de.wikipedia.org/wiki/Datei:Hand_external_anatomy,_dorsum.svg

Fig. 2
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Fig. 4

Adapted from https://www.mytriorings.com/cultural-differences-wearing-bridal-rings-on-the-left-or-the-right-hand

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Research Unit for Digital Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery Graz, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29, Graz, 8036, Austria

    Anna-Lisa Pignet, Daniel G. Gmainer, Birgit Michelitsch & David B. Lumenta

  2. Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Auenbruggerplatz 2, 8036, Graz, Austria

    Franz Quehenberger

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  1. Anna-Lisa Pignet
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  2. Daniel G. Gmainer
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  3. Birgit Michelitsch
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  4. Franz Quehenberger
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Anna-Lisa Pignet, Daniel G. Gmainer and David B. Lumenta. The first draft of the manuscript was written by Anna-Lisa Pignet, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. Conceptualization: David B. Lumenta; methodology: Franz Quehenberger; Anna-Lisa Pignet; Daniel G. Gmainer; formal analysis and investigation: Anna-Lisa Pignet, Daniel G. Gmainer, Birgit Michelitsch; writing — original draft preparation: Anna-Lisa Pignet; writing — review and editing: Daniel G. Gmainer, David B. Lumenta; supervision: David B. Lumenta.

Corresponding author

Correspondence to Daniel G. Gmainer.

Ethics declarations

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the Medical University of Graz (32-418 ex 19/20).

Consent to participate

The retrospective study was approved by the Ethics Committee on May 19, 2020. In accordance with Article 32 of the Declaration of Helsinki, Section 7 of the Austrian Data Protection Act and Section 2d of the Research Organization Act, it is not necessary to obtain consent from the subjects for the use of the data.

Conflict of interest

Anna-Lisa Pignet, Daniel G. Gmainer, Birgit Michelitsch, Franz Quehenberger, and David B. Lumenta declare no conflict of interest.

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Pignet, AL., Gmainer, D.G., Michelitsch, B. et al. Association of trigger finger release with extracorporeal constriction: a retrospective review of operated cases. Eur J Plast Surg 46, 403–408 (2023). https://doi.org/10.1007/s00238-022-02016-2

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  • DOI: https://doi.org/10.1007/s00238-022-02016-2

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