Evidence-based management of adult trigger digits

Amirfeyz, Rouin; McNinch, R; Watts, Adam C.; Rodrigues, Jeremy; Davis, T. R. C.; Glassey, Nicole; Bullock, James M.

doi:10.1177/1753193416682917

Cited by 50 publications

(43 citation statements)

References 25 publications

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“…We used the available evidence to inform a conversation between the surgeon and patient regarding each of the 6 attributes (eg, success rate) and their respective levels (eg, 50% success rate) for each attribute based on literature review and clinical practice patterns (Table 1). 2,5,[29][30][31][32][33][34][35][36][37][38][39][40][41] After discussion of the attributes and their levels for each treatment, the patients rank the attributes in order of importance using the tool (Qualtrics Research Software, Provo, UT). This approach has been used in prior studies.…”

Section: Tool Creationmentioning

confidence: 99%

“…Refer to Web version on PubMed Central for supplementary material. • Primary reported complication of therapy is stiffness (up to 27%) that "resolved quickly" 39 • Most common complications of injections include cellulitis, 30 steroid flare, fat necrosis 36 • Most common complications of surgery include major: synovial fluid cyst requiring excision, arthrofibrosis; minor: wound complications, stiffness, pain 27 Immobilization time T: nightly for ~3-9 wk I: none S: none • Levels based on literature review demonstrating a range of immobilization from 3 to 9 wk in the therapy group 37 Pain associated with treatment T: + I: ++ S: +++ • There is significant variation in definition and follow-up of pain associated with treatment in the literature 5,27,35…”

Section: Supplementary Materialsmentioning

confidence: 99%

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The Feasibility and Usability of a Ranking Tool to Elicit Patient Preferences for the Treatment of Trigger Finger

Shapiro

Eppler

Kamal

2019

The Journal of Hand Surgery

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Purpose-Shared decision making is an approach where physicians and patients collaborate to make decisions based on patient values. This requires eliciting patients' preferences for each treatment attribute before making decisions; a structured process for preference elicitation does not exist in hand surgery. We tested the feasibility and usability of a ranking tool to elicit patient preferences for the treatment of trigger finger. We hypothesized that the tool would be usable and feasible at the point of care. Methods-Thirty patients with a trigger finger without prior treatment were recruited from a hand surgery clinic. A preference elicitation tool was created that presented 3 treatment options (surgical release, injection, and therapy and orthosis) and described attributes of each treatment extracted from literature review (eg, success rate, complications). We presented these attributes to patients using the tool and patients ranked the relative importance (preference) of these attributes to aid in their decision making. The System Usability Scale and tool completion time were used to evaluate usability and feasibility, respectively. Results-The tool demonstrated excellent usability (System Usability Scale: 88.7). The mean completion time was 3.05 minutes. Five (16.7%) patients chose surgery, 20 (66.7%) chose an injection, and 5 (16.7%) chose therapy and orthosis. Patients ranked treatment success and cost as the most and least important attributes, respectively. Twenty-nine (96.7%) patients were very to extremely satisfied with the tool. Conclusions-A preference elicitation tool for patients to rank treatment attributes by relative importance is feasible and usable at the point of care. A structured process for preference elicitation ensures that patients understand the trade-offs between choices and can assist physicians in aligning treatment decisions with patient preferences. Clinical relevance-A ranking tool is a simple, structured process physicians can use to elicit preferences during shared decision making and highlight trade-offs between treatment options to inform treatment, choices.

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Section: Tool Creationmentioning

confidence: 99%

Section: Supplementary Materialsmentioning

confidence: 99%

The Feasibility and Usability of a Ranking Tool to Elicit Patient Preferences for the Treatment of Trigger Finger

Shapiro

Eppler

Kamal

2019

The Journal of Hand Surgery

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“…42 Steroid injections can be delivered in the primary care setting. Local injection of steroid helps with pain from flexor synovitis 43 as well as triggering 44 by reducing swelling and inflammation around the A1 pulley and the flexor tendons.…”

Section: Steroid Injectionmentioning

confidence: 99%

“…However, we would recommend referral to secondary care at this stage in keeping with recent guidelines from the British Society of Surgery of the Hand. 42 Patients with diabetes have a lower success rate of 52% to 66%, 67 68 and higher rates of recurrence or progression to surgery, 63 65 but they should still be offered a steroid injection. Warn them to expect elevated glucose levels for up to five days afterwards.…”

Section: Steroid Injectionmentioning

confidence: 99%

Acquired triggering of the fingers and thumb in adults

David

Rangaraju

Raine³

2017

BMJ

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“…Tetik parmak; fleksor tendonların, içinde hareket ettikleri 1.anüler (A1) pulleyde takılması ile oluşmaktadır (1). Cerrahi tedavi çoğu vakada kesin ve kalıcı bir çözüm sağlamaktadır (2,3). Günümüzde cerrahi insizyon olarak transvers ve/veya longitudinal insizyon tercih edilmektedir (4).…”

Section: Introductionunclassified

Surgical treatment of trigger finger? Longitudinal incision versus transverse incision?

Acar¹,

Serarslan²

2019

Kocaeli Med J

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1Kocaeli Derince Eğitim ve Araştırma Hastanesi,Ortopedi ve Travmatoloji Kliniği, El cerrahisi Ünitesi, Kocaeli, Türkiye. 2Kocaeli Derince Eğitim ve Araştırma Hastanesi,Ortopedi ve Travmatoloji Kliniği, Kocaeli, Türkiye. ÖZ GİRİŞ ve AMAÇ: Cerrahi uygulanan tetik parmak hastalarında, longitudinal insizyon ile transvers insizyon arasında fark olup olmadığı değerlendirildi. YÖNTEM ve GEREÇLER: Çalışmaya, Kasım 2017 ile Ekim 2018 tarihleri arasında tetik parmak cerrahisi yapılan 24 hasta (16 bayan, 8 erkek) dahil edildi. Bu hastalar Wolfe sınıflamasına göre değerlendirildi. Bu hastalarda yineleme oranı ve memnuniyet oranları değerlendirildi. Cerrahi sonrası sinir hasarı, yara yeri enfeksiyonu ve yarada açılma gibi komplikasyonlar değerlendirilmiştir. BULGULAR: Hastaların yaş ortalaması 51,4 (32-72). Wolfe sınıflamasına göre 10 (%41,6) olgu evre 2, 14 (%58,4) olgu evre 3 idi. Hastaların 16'sı (%66,7) bayan, 8'i (%33,3) erkek idi. Hastalar ortalama 8 ay (5-11) takip edildi. Her 2 grupta da yineleme izlenmedi. Hastaların tamamı, cerrahi tedaviden memnun kaldıklarını belirtti. TARTIŞMA ve SONUÇ: Tetik parmak cerrahisi; nüks ve komplikasyon gelişmemesi açısından yararlı bir yöntem olmakla birlikte, uygulanan iki ayrı cerrahi insizyon arasında fark olmadığı görüldü. Anahtar Kelimeler: cerrahi tedavi, longitudinal insizyon, tetik parmak, transvers insizyon ABSTRACT INTRODUCTION: In this study, we aimed to evaluate the efficacy of longitudinal incision versus transverse incision in the surgical treatment of trigger finger. METHODS: Between November 2017 and October 2018, a total of 24 patients who were surgically treated for trigger finger using longitudinal incision or transverse incision were included. Trigger finger was graded according to the Wolfe classification. The rates of recurrence and patient satisfaction were evaluated. Postoperative complications including nerve injury, wound site infection, and wound dehiscence were noted. RESULTS:Of the patients, 16 (66.7%) were females and 8 (33.3%) were males with a mean age of 51.4 (range, 32 to 72) years. The mean follow-up was 8 (range, 5 to 11) months. According to the Wolfe classification, 10 patients (41.6%) had Grade 2 and 14 patients (58.4%) Grad 3 disease. A longitudinal incision was used in 12 patients (50%), while a transverse incision was used in 12 patients (50%). None of the patients had recurrence after surgery. Patient satisfaction was achieved in all patients operated. DISCUSSION AND CONCLUSION:Our study results suggest that surgical treatment of trigger finger is an effective method without any recurrence or complication and both incision techniques yield similar outcomes.

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Evidence-based management of adult trigger digits

Abstract: I.

Cited by 50 publications

References 25 publications

The Feasibility and Usability of a Ranking Tool to Elicit Patient Preferences for the Treatment of Trigger Finger

The Feasibility and Usability of a Ranking Tool to Elicit Patient Preferences for the Treatment of Trigger Finger

Acquired triggering of the fingers and thumb in adults

Surgical treatment of trigger finger? Longitudinal incision versus transverse incision?

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