Acta Scientific Orthopaedics (ISSN: 2581-8635)

Review Article Volume 3 Issue 5

Percutaneous or Open Release is the Most Effective Surgical Technique in Diabetic Recurrent Trigger Finger in Short and Long Term Outcomes? A Clinical Review

Grigorios Kastanis1*, Pantouvaki A2, Spyrantis M1, Christoforidis C1 and Velivasakis G1

1Department of Orthopaedic, General Hospital of Heraklion-Venizeleio, Crete, Greece
2Department of Physiotherapy, General Hospital of Heraklion-Venizeleio, Crete, Greece

*Corresponding Author: Grigorios Kastanis, Department of Orthopaedic, General Hospital of Heraklion-Venizeleio, Crete, Greece.

Received: March 27, 2020; Published: April 23, 2020

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Abstract

Introduction: Stenosing Tenosynovitis is a common disorder among patients with diabetes mellitus. The definitive treatment is release of the A1 pulley (open or percutaneous). The aim of this study is to compare functional outcomes and complication rates of these two methods (open versus percutaneous release) for recurrent trigger finger in patients with diabetes mellitus.

Materials and Methods: 114 patients with diabetes mellitus and an average age of 48 years (range 28 - 64 yrs old) were treated for recurrent trigger finger. The modified Quinnell grading system was used as a selection criterion for the classification of trigger digit. The patients were divided in two groups randomly. Group A included 52 patients who were treated with open release of A1 pulley and group B included 62 patients who were treated with percutaneous release using the tip of an 18-gauge or knife (Ophthalmic Corneal/Scleral knife 19 Gauge).

Results: The median follow-up was 12 months (range from 10 - 14 months). The results were based on the Visual Analogue Scale (VAS), Quick Dash and Gilberts and Wereldasma Questionnaire. At 3 months, the results seemed to be better in group B, while there was no statistical difference at six months and at one year postoperatively.

Conclusion: Both surgical methods (open and percutaneous release) in long-term follow-up postoperatively, resulted in similar therapeutic efficacy. The advantages of percutaneous release over the classic open method in short-term outcomes are: 1) low cost, 2) less complication rates and 3) immediate functional recovery.

Keywords: Grigorios Kastanis, Department of Orthopaedic, General Hospital of Heraklion-Venizeleio, Crete, Greece.

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References

  1. Yadav A., et al. “Comparison between Percutaneous release and Corticosteroid injection in the management of trigger digits”. International Journal of Orthopaedics Sciences3 (2017): 21-26.
  2. Saldana M. “Trigger digits: diagnosis and treatment”. The Journal of the American Academy of Orthopaedic Surgeons 9 (2001): 246-252.
  3. Fitzgerald B., et al. “Gout affecting the hand and wrist”. The Journal of the American Academy of Orthopaedic Surgeons 15 (2007): 625-635.
  4. Freiberg A., et al. “Nonoperative treatment of trigger fingers and thumbs”. The Journal of Hand Surgery American 3 (1989): 553-558.
  5. Langer D., et al. “Evaluating hand function in clients with trigger finger”. Occupational Therapy International (2017): 9539206.
  6. Brozovich N., et al. “A Critical Appraisal of Adult Trigger Finger: Pathophysiology, Treatment, and Future Outlook”. Plastic and Reconstructive Surgery 7 (2019): e2360.
  7. Wiwanitkit S and Wiwanitkit V. “Trigger Digits and Diabetes Mellitus”. North American Journal of Medical Sciences3 (2012): 117-119.
  8. Hansen RL., et al. “Open surgery versus ultrasound-guided corticosteroid injection for trigger finger: a randomized controlled trial with 1-year follow-up”. The Journal of Hand Surgery American 42 (2017): 359-366.
  9. Hoang D., et al. “Evaluation of percutaneous first annular pulley release: efficacy and complications in a perfused cadaveric study”. The Journal of Hand Surgery 41 (2016): e165-e173.
  10. Wilhelmi BJ., et al. “Trigger finger release with hand surface landmark ratios: an anatomic and clinical study”. Plastic and Reconstructive Surgery 4 (2001): 908-915.
  11. Hazani R., et al. “Assessment of the distal extent of the A1 pulley release: a new technique”. Eplasty8 (2008): e44.
  12. Vance MC., et al. “The association of hemoglobin A1c with the prevalence of stenosing flexor tenosynovitis”. The Journal of Hand Surgery 9 (2012): 1765-1769.
  13. Abate M., et al. “Management of limited joint mobility in diabetic patients”. Diabetes, Metabolic Syndrome and Obesity Targets 6 (2013): 197-207.
  14. Ferree S., et al. “Risk factors for return with a second trigger digit”. The Journal of Hand Surgery European 39 (2014): 704-707.
  15. Nimigan AS., et al. “Steroid injections in the management of trigger fingers”. American Journal of Physical Medicine and Rehabilitation 85 (2006): 36-43.
  16. Colbourn J., et al. “Effectiveness of splinting for the treatment of trigger finger”. Journal of Hand Therapy 4 (2008): 336-343.
  17. Monreal R., et al. “Percutaneous Trigger Finger Release in Outpatient Clinics”. Clinical Research in Orthopaedic2 (2018): 1-3.
  18. Saremi H., et al. “Percutaneous Release of Trigger Fingers: Comparing Multiple Digits with Single Digit Involvement”. The Archives of Bone and Joint Surgery 3 (2016): 224-227.
  19. Turowski GA., et al. “The results of surgical treatment of trigger finger”. The Journal of Hand Surgery 22A (1997): 145-149.
  20. Sato ES., et al. “Percutaneous release of trigger fingers”. Hand Clinics1 (2014): 39-45.
  21. Sheikh E., et al. “A prospective randomized trial comparing the effectiveness of one versus two (staged) corticosteroid injections for the treatment of stenosing tenosynovitis”. Hand (NY) 9 (2014): 340-345.
  22. Sahu RL and Gupta P. “Experience of percutaneous trigger finger release under local anesthesia in the medical college of Mullana, Ambala, Haryana”. Annals of Medical and Health Science Research 5 (2015): 806.
  23. Kuczmarski AS., et al. “Management of diabetic trigger finger”. Journal of Hand Surgery American 2 (2019): 150-153.
  24. Brown E and Genoway KA. “Impact of diabetes on outcomes in hand surgery”. The Journal of Hand Surgery American 12 (2011): 2067-2072.
  25. Pandey BK., et al. “Percutaneous trigger finger release”. Nepal Orthopaedic Association Journal1 (2010): 25-29.
  26. Aksoy A and Sir E. “Complications of Percutaneous Release of the Trigger Finger”. Cureus2 (2019): e4132.
  27. Elsayed MM. “Percutaneous release of trigger finger”. The Egyptian Orthopaedic Association3 (2013): 277-281.
  28. Lin AJ., et al. “Open versus percutaneous release for trigger digits: Reversal between short – term and long-term outcomes”. Journal of the Chinese Medical Association 79 (2016): 340-344.
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Citation

Citation: Grigorios Kastanis., et al. “Percutaneous or Open Release is the Most Effective Surgical Technique in Diabetic Recurrent Trigger Finger in Short and Long Term Outcomes? A Clinical Review". Acta Scientific Orthopaedics 3.5 (2020): 33-38.




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