{"title":"Comparative results of percutaneous and open surgery for trigger fingers: a propensity score analysis.","authors":"Praphan Chanthanapodi, Sasithorn Aodsup","doi":"10.3389/fsurg.2025.1509292","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>Trigger finger is a common hand condition characterized by the locking of a digit, often requiring surgical intervention when conservative treatments fail. This study aimed to compare the outcomes of a modified percutaneous release technique with those of traditional open release surgery.</p><p><strong>Materials and methods: </strong>A retrospective cohort study was conducted on 245 patients (287 digits), of which 161 digits underwent open release and 126 underwent percutaneous release. A modified technique for percutaneous release was described. Propensity score matching was used to balance the data. Cox regression and Laplace regression were applied to analyze the hazard ratio and median survival time for pain relief and time to return to work. Adverse events were also reported.</p><p><strong>Results: </strong>The duration of pain relief in the percutaneous release group was shorter than that in the open release group (hazard ratio = 1.73, 95% CI: 0.98-3.06; <i>p</i> = 0.057). Fifty percent of patients in the percutaneous release group experienced pain relief within two days, compared to seven days in the open release group (<i>p</i> = 0.003). Time to return to work was significantly shorter in the percutaneous release group than in the open release group (hazard ratio = 2.93, 95% CI: 2.08-4.13; <i>p</i> < 0.001). Fifty percent of patients in the percutaneous release group returned to work within three days, compared to 15 days in the open release group (<i>p</i> < 0.001). Three digits (2.4%) required conversion to open release due to the failure of percutaneous release. No nerve injuries or recurrences were observed at a follow-up of 42.2 ± 2.2 months.</p><p><strong>Conclusions: </strong>Percutaneous release resulted in an earlier return to work and a high success rate (97.6%) with no nerve injuries or recurrences over 42 months. Despite a 2.4% failure rate, careful technique minimized complications. Further randomized trials are needed to confirm these findings and optimize patient selection.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1509292"},"PeriodicalIF":1.6000,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922895/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fsurg.2025.1509292","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Background and objectives: Trigger finger is a common hand condition characterized by the locking of a digit, often requiring surgical intervention when conservative treatments fail. This study aimed to compare the outcomes of a modified percutaneous release technique with those of traditional open release surgery.
Materials and methods: A retrospective cohort study was conducted on 245 patients (287 digits), of which 161 digits underwent open release and 126 underwent percutaneous release. A modified technique for percutaneous release was described. Propensity score matching was used to balance the data. Cox regression and Laplace regression were applied to analyze the hazard ratio and median survival time for pain relief and time to return to work. Adverse events were also reported.
Results: The duration of pain relief in the percutaneous release group was shorter than that in the open release group (hazard ratio = 1.73, 95% CI: 0.98-3.06; p = 0.057). Fifty percent of patients in the percutaneous release group experienced pain relief within two days, compared to seven days in the open release group (p = 0.003). Time to return to work was significantly shorter in the percutaneous release group than in the open release group (hazard ratio = 2.93, 95% CI: 2.08-4.13; p < 0.001). Fifty percent of patients in the percutaneous release group returned to work within three days, compared to 15 days in the open release group (p < 0.001). Three digits (2.4%) required conversion to open release due to the failure of percutaneous release. No nerve injuries or recurrences were observed at a follow-up of 42.2 ± 2.2 months.
Conclusions: Percutaneous release resulted in an earlier return to work and a high success rate (97.6%) with no nerve injuries or recurrences over 42 months. Despite a 2.4% failure rate, careful technique minimized complications. Further randomized trials are needed to confirm these findings and optimize patient selection.
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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