Comparative results of percutaneous and open surgery for trigger fingers: a propensity score analysis.

IF 1.6 4区医学 Q2 SURGERY Frontiers in Surgery Pub Date : 2025-03-06 eCollection Date: 2025-01-01 DOI:10.3389/fsurg.2025.1509292

Praphan Chanthanapodi, Sasithorn Aodsup

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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.

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经皮手术和开放手术治疗扳机指的比较结果：倾向评分分析。

背景和目的：扳机指是一种常见的手部疾病，以手指锁定为特征，保守治疗失败时通常需要手术干预。本研究旨在比较改良的经皮释放技术与传统的开放释放手术的结果。材料与方法：对245例患者（287指）进行回顾性队列研究，其中开放松解161例，经皮松解126例。本文描述了一种改良的经皮释放技术。使用倾向评分匹配来平衡数据。采用Cox回归和Laplace回归分析风险比、缓解疼痛的中位生存时间和恢复工作时间。不良事件也有报道。结果：经皮释放组疼痛缓解时间短于开放释放组(风险比= 1.73,95% CI: 0.98-3.06；p = 0.057)。经皮释放组50%的患者在2天内疼痛缓解，而开放释放组为7天（p = 0.003）。经皮释放组恢复工作时间明显短于开放释放组(风险比= 2.93,95% CI: 2.08-4.13；结论：经皮释放术恢复工作时间早，成功率高（97.6%），42个月无神经损伤或复发。尽管失败率为2.4%，但谨慎的技术将并发症降至最低。需要进一步的随机试验来证实这些发现并优化患者选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

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.