Purpose
This study aimed to investigate the incidence and prognostic factors for prolonged
postoperative symptoms after open A1 pulley release in patients with trigger finger,
despite absence of any complications.
Methods
We reviewed 109 patients (78 single-finger involvement, 31 multiple-finger involvement)
who underwent open A1 pulley release for trigger finger from 2010 to 2016, with 8
weeks or longer postsurgical follow-up and without postoperative complications. The
group had 16 men and 93 women, with mean age of 56 years (range, 21–81 years), and
average follow-up period of 24.8 weeks (range, 8.0–127.4 weeks). Prolonged postoperative
symptoms were defined as symptoms persisting for longer than 8 weeks after surgery.
Factors analyzed for delay in recovery included duration of preoperative symptoms;
number of preoperative local corticosteroid injections; preoperative flexion contracture
of proximal interphalangeal (PIP) joint; multiplicity of trigger finger lesions; occupation;
presence of type 2 diabetes mellitus, other hand disorders like carpal tunnel syndrome,
de Quervain disease, or Dupuytren contracture; and fraying or partial tear of the
flexor tendon.
Results
Twenty-six fingers (19.3%) showed prolonged postoperative symptoms, with mean time
until complete relief being 14.0 ± 6.4 weeks (range, 9–34 weeks). Risk factors associated
with prolonged postoperative symptoms included duration of preoperative symptoms,
preoperative flexion contracture of the PIP joint, and fraying or partial tear of
the flexor tendon.
Conclusions
Physicians should consider the duration of preoperative symptoms and preoperative
flexion contracture of the PIP joint when deciding timing of surgery for trigger finger
patients. In addition, they should explain to patients with a positive history of
these factors and in whom flexor tendon injury is found during surgery about the possibility
of prolonged postoperative symptoms.
Type of study/level of evidence
Prognostic IV.
Key words
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Article info
Publication history
Published online: July 25, 2018
Accepted:
June 22,
2018
Received:
August 23,
2017
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2019 by the American Society for Surgery of the Hand. All rights reserved.
