Risk Factors for Complications of Open Trigger Finger Release

Abstract

Background Open trigger finger release is generally considered a simple low-risk procedure. Reported complication rates vary widely from 1 to 43 %, mostly based on small studies. Our goal was to determine the incidence of complications in a large consecutive series, while also identifying potential risk factors. Methods All open trigger finger releases performed from 2006 to 2009 by four fellowship-trained hand surgeons at a single institution were retrospectively reviewed. There were 795 digits released in 543 patients. Complications were defined as signs or symptoms requiring further treatment and/or considered unresolved by 1 month postoperatively. Complications requiring operative intervention were regarded as major. Multivariable analysis was performed to determine possible risk factors for complications. Results There were 95 documented complications among 795 digits (12 %). The most common complications involved persistent pain, stiffness, or swelling, persistent or recurrent triggering, or superficial infection. Most were treated nonoperatively with observation, therapy, steroid injection, or oral antibiotics. There were 19 reoperations (2.4 %), mostly including revision release, tenosynovectomy, and irrigation and debridement. Male gender, sedation, and general anesthesia were independently associated with complications, while age, diabetes, hypothyroidism, recent injection, and concurrent procedures were not associated.Conclusions Open trigger finger release is generally a lowrisk procedure, although there is potential for complications, some requiring reoperation. Male gender, sedation, and general anesthesia may be associated with greater risk. Surgeons should be careful to thoroughly discuss the risk of both major and minor complications when counseling patients.

Steroid Injection and Open Trigger Finger Release Outcomes: A Retrospective Review of 999 Digits

“…9 Retrospective studies in the past few decades have extensively reported postoperative complications after open trigger finger release, such as persistent or recurrent triggering, nerve injury, infection, wound problems, and slow recov-ery of motion requiring hand therapy. 2,4,7,17,19,23 However, only 1 study to date has specifically examined recent steroid injection as a factor associated with complications in open trigger release. In a 2014 retrospective review of many potential risk factors, Everding et al 7 found that age, diabetes, hypothyroidism, recent injection, and concurrent procedures were not associated with a greater incidence of complications (persistent pain, swelling, stiffness, recurrent triggering, infection, neurapraxia, bowstringing) in 795 digits belonging to 543 patients.…”

“…2,4,7,17,19,23 However, only 1 study to date has specifically examined recent steroid injection as a factor associated with complications in open trigger release. In a 2014 retrospective review of many potential risk factors, Everding et al 7 found that age, diabetes, hypothyroidism, recent injection, and concurrent procedures were not associated with a greater incidence of complications (persistent pain, swelling, stiffness, recurrent triggering, infection, neurapraxia, bowstringing) in 795 digits belonging to 543 patients. However, anecdotal evidence among hand surgeons has continued to question whether or not recent steroid injection may be related to complications following open trigger finger release.…”

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

“…Tetik parmak cerrahisi sonrası komplikasyonlarda risk faktörü olarak; erkek cinsiyet, ameliyatın sedasyon altında ve genel anestezi altında olması kabul edilmektedir (16). Çalışmamızdaki olguların çoğu bayan olup, ameliyat sırasında rejyonel anestezi uygulanması sebebi ile herhangi bir komplikasyon görülmemiştir.…”

Acquired triggering of the fingers and thumb in adults

“…89 The overall complication rate is 12% in one series of 795 trigger fingers treated surgically, with major complications necessitating return to theatre occurring in 2.4%. 90 Minor issues include scar pain, superficial infection, stiffness (3%), and protracted wound care (2%). 86 Bowstringing from over-release of the pulley system 91 and nerve injuries 86 …”