Incidence and Predictors of Subsequent Triggering Requiring Treatment After Trigger Finger Release.

IF 2.1 2区 医学 Q2 ORTHOPEDICS
Nicholas B Pohl, Parker L Brush, Jory P Parson, Patrick Fitzgerald, Alex Charlton, Pedro K Beredjiklian, Daniel J Fletcher
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引用次数: 0

Abstract

Purpose: To assess the incidence of subsequent treatment of trigger finger in the same or additional digits after the initial trigger finger release, as well as identify patient characteristics associated with the need for subsequent treatment.

Methods: This study retrospectively analyzed 1,715 patients with a trigger finger who underwent surgical release from 2015 to 2017. Bivariate analysis was performed to determine the percentage of patients requiring further trigger finger treatment by either steroid injection or operative release. Patient factors were then compared in those who did and did not undergo subsequent treatment. Cox proportional hazards models and survival analysis were performed to identify patient characteristics associated with requiring subsequent treatment, injection, and surgery.

Results: Overall, 690 (40.2%) patients required subsequent treatment with either steroid injection or surgical release in either the same or an additional finger. Four hundred sixty patients (26.8%) underwent at least one subsequent injection, with 36 (2.1%) of these on the same finger. Additionally, 230 (13.4%) patients received at least one subsequent first annular pulley release, with 14 (0.8%) on the same finger as the initial release. Cox proportional hazards models showed patients with a higher comorbidly burden and current smoking status were more likely to receive subsequent treatment. Higher body mass index and greater comorbidity burden were also associated with requiring subsequent surgery. Additionally, current smokers or patients with a greater comorbidity burden had a higher risk of requiring subsequent treatment in an additional digit not initially released.

Conclusions: Subsequent release or injection in the same or another digit was common following an initial trigger finger release. Patient characteristics such as higher body mass index and greater comorbidity burden were associated with requiring subsequent surgery, and smoking status as well as comorbidity burden were associated with subsequent treatment in an additional digit not initially released.

Type of study/level of evidence: Prognostic IV.

目的:评估初次扳机指松解术后同一或其他手指扳机指后续治疗的发生率,并确定与后续治疗需求相关的患者特征:本研究回顾性分析了2015年至2017年接受手术松解的1715例扳机指患者。通过双变量分析,确定需要通过类固醇注射或手术松解进一步治疗扳机指的患者比例。然后比较了接受和未接受后续治疗的患者因素。通过 Cox 比例危险模型和生存分析,确定与需要后续治疗、注射和手术相关的患者特征:总计有 690 名患者(40.2%)需要接受后续治疗,对同一手指或其他手指进行类固醇注射或手术松解。460 名患者(26.8%)至少接受了一次后续注射,其中 36 例(2.1%)注射在同一手指上。此外,230 名患者(13.4%)接受了至少一次后续的第一环轮松解术,其中 14 人(0.8%)的第一环轮松解术与首次松解术在同一手指上进行。Cox比例危险模型显示,合并症较多且目前吸烟的患者更有可能接受后续治疗。体重指数较高和合并症较多的患者也与需要后续手术有关。此外,当前吸烟者或合并症负担较重的患者需要在最初未释放的额外部位接受后续治疗的风险更高:结论:在初次扳机指松解术后,在同一或另一手指上进行后续松解或注射的情况很常见。研究类型/证据级别:预后 IV 级。
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来源期刊
CiteScore
3.20
自引率
10.50%
发文量
402
审稿时长
12 weeks
期刊介绍: The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.
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