JOMPAC
Journal of Medicine and Palliative Care

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

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Original Article
Long-term outcomes of percutaneous release technique or open for trigger finger in diabetic patients
Abstract
Aims: Trigger finger is seen more often in diabetic patients and can lead to more serious postoperative complications compared to non-diabetic patients. The aim of this study was to compare the outcomes of open and percutaneous release techniques in diabetic patients.
Methods: This retrospective study included 62 patients who met the study criteria. Of these patients, 32 underwent open release surgery and 30 underwent percutaneous release with an 18-gauge needle. The patients were evaluated retrospectively in respect of the data on first presentation preoperatively and at postoperative follow-up examinations at 3 weeks, 6 months and 1 year. A retrospective examination was made of the demographic data, Visual Analog Scale (VAS) scores preoperatively, at 6 and 12 months postoperatively, recurrence rates at the end of 6 months and 1 year, the Quinnell grading scale at the end of 1 year, wound site infection, tendon damage and neurovascular complications. VAS scores and the Quinnell grading scale were used for clinical evaluation.
Results: The data of a total of 62 patients were statistically analyzed in the study, with 32 (51.6%) in the Open group and 30 (48.4%) in the Percutaneous group. The mean age of the patients was 58.97±7.51 (min-max: 45-72) years. The distributions of trigger finger and Quinnell grading system scores were statistically similar between the groups (P=0.974, P=0.279, respectively). The recurrent triggering rate at the 6th and 12th month was significantly higher in the Percutaneous group (P=0.049, P=0.049, respectively). The average return to work duration in the Percutaneous group (1.70±0.75) was significantly shorter than that in the Open group (3.88±1.21) (P<0.001). Pre-op, Post-op 6th and 12th month VAS scores did not significantly differ between the groups (P=0.466, P=0.356, P=0.175, respectively).
Conclusion: Although satisfactory results were obtained with both percutaneous and open release techniques in the patients with diabetes in this study, the percutaneous release technique was seen to be a method which can be easily performed in an outpatient setting and had fewer complications.

Keywords : Trigger finger, percutaneous, diabetic patients, open surgery, Quinnell grading

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1. Saremi H, Hakhamaneshi E, Rabiei MA:Percutaneous releaseof trigger fingers:comparing multiple digits with single digitinvolvement. Arch Bone J Surg. 2016;4:224-227.
2. Bonnici AV, Spencer JD. A survey of &lsquo;trigger finger&rsquo; in adults. JHand Surg Br. 1988;13:202-203.
3. Saldana MJ. Trigger digits:diagnosis and treatment. J Am AcadOrthop Surg. 2001;9(4):246-252.
4. Paulius KL, Maguina P. Ultrasound-assisted percutaneous triggerfinger release:is it safe? Hand (N Y). 2009;4:35-37.
5. Hansen RL, S&oslash;ndergaard M, Lange J. Open surgery versusultrasound-guided corticosteroid injection for trigger finger:arandomized controlled trial with 1-year follow-up. J Hand SurgAm. 2017;42(5):359-366.
6. Rojo-Manaute JM, Soto VL, De las Heras S&aacute;nchez- Heredero J,Del Valle Soto M, Del Cerro-Guti&eacute;rez M, Mart&iacute;n JV. Percutaneousintrasheath ultrasonographically guided first annular pulleyrelease:anatomic study of a new technique. J Ultrasound Med.2010;29(11):1517-1529.
7. Rajeswaran G, Lee JC, Eckersley R, Katsarma E, Healy JC.Ultrasound-guided percutaneous release of the annular pulley intrigger digit. Eur Radiol. 2009;19(9):2232- 2237.
8. Abe Y. Clinical results of a percutaneous technique for trigger digitrelease using a 25-gauge hypodermic needle with corticosteroidinfiltration. J Plast Reconstr Aesthet Surg. 2016;69(2):270-277.
9. Bruijnzeel H, Neuhaus V, Fostvedt S, Jupiter JB, MudgalCS, Ring DC. Adverse events of open A1 pulley release foridiopathic trigger finger. J Hand Surg Am. 2012;37(8):1650-1656.doi:10.1016/j.jhsa.2012.05.014
10. Will R, Lubahn J. Complications of open trigger finger release. JHand Surg Am. 2010;35(4):594-596. doi:10.1016/j.jhsa.2009.12.040
11. Slesarenko YA, Mallo G, Hurst LC, Sampson SP, Serra-Hsu F.Percutaneous release of A1 pulley. Tech Hand Up Extrem Surg.2006;10(1):54-56. doi:10.1097/00130911-200603000-00010
12. Kerrigan C, Stanwix M:Using evidence to minimize the cost oftrigger finger care . J Hand Surg. 2009;34:997-1005.
13. Elsayed MM. Percutaneous release of trigger finger. Egypt OrthopJ. 2013;48:277-281.
14. Huang HK, Wang JP, Wang ST, Liu YA, Huang YC, Liu CL.Outcomes and complications after percutaneous release fortrigger digits in diabetic and non-diabetic patients. J Hand SurgEur Vol. 2015;40(7):735-739. doi:10.1177/1753193415590389
15. Froimson AI. In: DP Green, editor. Operative hand surgery. 3rded. New York: Churchill Livingstone. (1993). p. 1995-1998.
16. Fiorini HJ, Santos JB, Hirakawa CK, Sato ES, Faloppa F, AlbertoniWM. Anatomical study of the A1 pulley: length and location bymeans of cutaneous landmarks on the palmar surface. J HandSurg Am. 2011;36(3):464-468. doi:10.1016/j.jhsa.2010.11.045
17. Sheikh E, Peters JD, Sayde W, Maltenfort M, Leinberry C. Aprospective randomized trial comparing the effectiveness of oneversus two (staged) corticosteroid injections for the treatment ofstenosing tenosynovitis. Hand (N Y). 2014;9(3):340-345.
18. Aksoy A, Sir E. Complications of percutaneous release of thetrigger finger. Cureus. 2019;11(2):e4132. doi:10.7759/cureus.4132
19. Bain GI, Turnbull J, Charles MN, Roth JH, Richards RS.Percutaneous A1 pulley release: a cadaveric study. J Hand SurgAm. 1995;20(5):781-786. doi:10.1016/S0363-5023(05)80430-7
20. Mishra SR, Gaur AK, Choudhary MM, Ramesh J. PercutaneousA1 pulley release by the tip of a 20-g hypodermic needlebefore open surgical procedure in trigger finger management.Tech Hand Up Extrem Surg. 2013;17(2):112-115. doi:10.1097/BTH.0b013e31828ef983
21. Stahl S, Kanter Y, Karnielli E. Outcome of trigger finger treatmentin diabetes. J Diabetes Complications. 1997;11(5):287-290
22. Bruijnzeel H, Neuhaus V, Fostvedt S, Jupiter JB, Mudgal CS,Ring DC. Adverse events of open A1 pulley release for idiopathictrigger finger. J Hand Surg Am. 2012;37(8):1650-1656
23. Gilberts EC, Beekman WH, Stevens HJ, Wereldsma JC.Prospective randomized trial of open versus percutaneoussurgery for trigger digits. J Hand Surg Am. 2001;26(3):497-500.doi:10.1053/jhsu.2001.24967
Article available in :
Volume 4, Issue 4, 2023
Page : 323-328
https://doi.org/10.47582/jompac.1327488
Article Information
Received : 14 Tem 2023
Accepted : 18 Ağu 2023
Published : 30 Ağu 2023
Corresponding Author :

Abdulrahim Dündar: Hitit University Erol Olçok Training and Research Hospital, Çorum, Turkey

[email protected]
Citation : Dündar A, İpek D, Kaya Ş. Long-term outcomes of percutaneous release technique or open for trigger finger in diabetic patients. J Med Palliat Care. 2023;4(4):323-328.

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