Outcomes and complications after percutaneous release for trigger digits in diabetic and non-diabetic patients

Abstract

We compared the short-term (3 months) and long-term (2 years) outcomes and complications of percutaneous release of 187 trigger digits of 154 patients treated between 2009 and 2012, all treated by a single surgeon. The 154 patients included 48 patients with diabetes mellitus and 106 non-diabetic patients. The only short-term complication was pain, occurring in three digits (5%) in the diabetic patients and six digits (5%) in the non-diabetic patients. The long-term complications were pain in 15 digits (25%) in the diabetic patients and 18 digits (14%) in the non-diabetic patients. This was not significant (p = 0.058). Recurrent triggering occurred in nine digits (15%) in the diabetic patients, which was significantly greater than the six digits (5%) in the non-diabetic patients (p = 0.013). The non-diabetic patients were significantly more satisfied.

Level of Evidence: level III

Keywords

Diabetes trigger finger percutaneous release treatment trigger digit

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References

Baumgarten

Gerlach

Boyer

. Corticosteroid injection in diabetic patients with trigger finger. A prospective, randomized, controlled double-blinded study. J Bone Joint Surg Am. 2007, 89: 2604–11.

Brown

Genoway

. Impact of diabetes on outcomes in hand surgery. J Hand Surg Am. 2011, 36: 2067–72.

Bruijnzeel

Neuhaus

Fostvedt

. Adverse events of open A1 pulley release for idiopathic trigger finger. J Hand Surg Am. 2012, 37: 1650–6.

Bykowski

Sivak

Cray

. Assessing the impact of antibiotic prophylaxis in outpatient elective hand surgery: a single-center, retrospective review of 8,850 cases. J Hand Surg Am. 2011, 36: 1741–7.

Calleja

Tanchuling

Alagar

. Anatomic outcome of percutaneous release among patients with trigger finger. J Hand Surg Am. 2010, 35: 1671–4.

Ferree

Neuhaus

Becker

Jupiter

Mudgal

Ring

. Risk factors for return with a second trigger digit. J Hand Surg Eur. 2014, 39: 704–7.

Gilberts

Wereldsma

. Long-term results of percutaneous and open surgery for trigger fingers and thumbs. Int Surg. 2002, 87: 48–52.

Gulabi

Cecen

Bekler

Saglam

Tanju

. A study of 60 patients with percutaneous trigger finger releases: clinical and ultrasonographic findings. J Hand Surg Eur. 2014a, 39: 699–703.

Gulabi

Cecen

Guclu

Cecen

. Carpal tunnel release in patients with diabetes result in poorer outcome in long-term study. Eur J Orthop Surg Traumatol. 2014b, 24: 1181–4.

10.

Kameyama

Chen

Mukai

. Histopathological characteristics of stenosing flexor tenosynovitis in diabetic patients and possible associations with diabetes-related variables. J Hand Surg Am. 2013, 38: 1331–9.

11.

Koh

Nakamura

Hattori

. Trigger digits in diabetes: their incidence and characteristics. J Hand Surg Eur. 2010, 35: 302–5.

12.

Lin

Wang

. Technique (open versus percutaneous) influence short- and long-term results of trigger fingers and trigger thumb release. Submitted.

13.

Patel

Moradia

. Percutaneous release of trigger digit with and without cortisone injection. J Hand Surg Am. 1997, 22: 150–5.

14.

Pope

Wolfe

. Safety and efficacy of percutaneous trigger finger release. J Hand Surg Am. 1995, 20: 280–3.

15.

Quinnell

. Conservative management of trigger finger. Practitioner. 1980, 224: 187–90.

16.

Ryzewicz

Wolf

. Trigger digits: principles, management, and complications. J Hand Surg Am. 2006, 31: 135–46.

17.

Sato

Dos Santos

Belloti

. Percutaneous release of trigger fingers. Hand Clin. 2014, 30: 39–45.

18.

Sheikh

Peters

Sayde

. A prospective randomized trial comparing the effectiveness of one versus two (staged) corticosteroid injections for the treatment of stenosing tenosynovitis. Hand (NY). 2014, 9: 340–5.

19.

Slesarenko

Mallo

Hurst

. Percutaneous release of A1 pulley. Tech Hand Up Extrem Surg. 2006, 10: 54–6.

20.

Tang

. Outcomes and evaluation of flexor tendon repair. Hand Clin. 2013, 29: 251–9.

21.

Taylor

Osei

Jain

. Digital artery pseudoaneurysm following percutaneous trigger thumb release: A case report. J Bone Joint Surg Am. 2012, 94: e6.

22.

Turowski

Zdankiewicz

Thomson

. The results of surgical treatment of trigger finger. J Hand Surg Am. 1997, 22: 145–9.

23.

Will

Lubahn

. Complications of open trigger finger release. J Hand Surg Am. 2010, 35: 594–6.

24.

Zyluk

Puchalski

. A comparison of outcomes of carpal tunnel release in diabetic and non-diabetic patients. J Hand Surg Eur. 2013, 38: 485–8.