BACKGROUND Trigger digit is a common disorder of the hand associated with carpal tunnel syndrome.Carpal tunnel release(CTR)surgery may be a risk factor for trigger digit development;however,the association between sur...BACKGROUND Trigger digit is a common disorder of the hand associated with carpal tunnel syndrome.Carpal tunnel release(CTR)surgery may be a risk factor for trigger digit development;however,the association between surgical approach to CTR and postoperative trigger digit is equivocal.AIM To investigate patient risk factors for trigger digit development following either open carpal tunnel release(OCTR)or endoscopic carpal tunnel release(ECTR).METHODS This retrospective chart analysis evaluated 967 CTR procedures from 694 patients for the development of postoperative trigger digit.Patients were stratified according to the technique utilized for their CTR,either open or endoscopic.The development of postoperative trigger digit was evaluated at three time points:within 6 mo following CTR,between 6 mo and 12 mo following CTR,and after 12 mo following CTR.Firth’s penalized likelihood logistic regression was conducted to evaluate sociodemographic and patient comorbidities as potential independent risk factors for trigger digit.Secondary regression models were conducted within each surgical group to reveal any potential interaction effects between surgical approach and patient risk factors for the development of postoperative trigger digit.RESULTS A total of 47 hands developed postoperative trigger digit following 967 CTR procedures(4.9%).In total,64 digits experienced postoperative triggering.The long finger was most commonly affected.There was no significant difference between the open and endoscopic groups for trigger digit development at all three time points following CTR.Furthermore,there were no significant independent risk factors for postoperative trigger digit;however,within group analysis revealed a significant interaction effect between gender and surgical approach(P=0.008).Females were more likely to develop postoperative trigger digit than males after OCTR(OR=3.992),but were less likely to develop postoperative trigger digit than males after ECTR(OR=0.489).CONCLUSION Patient comorbidities do not influence the development of trigger digit following CTR.Markedly,gender differences for postoperative trigger digit may depend on surgical approach to CTR.展开更多
BACKGROUND Trigger finger is a common disorder of the hand that can cause disabling symptoms.Treatment options range from conservative management with observation and splinting,to surgical release,but there is current...BACKGROUND Trigger finger is a common disorder of the hand that can cause disabling symptoms.Treatment options range from conservative management with observation and splinting,to surgical release,but there is currently not a consensus on a treatment algorithm.AIM To determine patient preference for the treatment of trigger finger using an online survey.METHODS An online crowdsourcing platform,Amazon Mechanical Turk,was used to recruit participants for this study.Participants were led through a scenario in which they were diagnosed with trigger finger.They were then asked to rank their preference of treatment options from the following:Observation,splinting,corticosteroid injection,surgery.The results of the surveys were then analyzed using R software.RESULTS Of 323 participants completed the survey.7 participants were excluded because they failed to correctly answer the attention question,leaving 316 participants whose results were included.As a first choice for treatment 117(37%)of the included participants chose observation,86(27%)chose splinting,61(19%)chose corticosteroid injection,and 52(16%)chose surgery.The mean rank for observation was 2.26,for splinting was 2.30,for corticosteroid injection was 2.53,and for surgery was 2.91.The ranking of each treatment option was statistically different(P value<0.05)from the others except for observation and splinting.CONCLUSION The practice of shared decision making with patients is imperative to providing the best care possible.The results from this study,especially the preference for less invasive treatment,may help providers better frame discussion around treatment options of trigger fingers.This in turn,may increase patient satisfaction in the treatment of trigger finger.展开更多
基金Supported by the Blue Cross Blue Shield of Michigan Foundation,No.22590764
文摘BACKGROUND Trigger digit is a common disorder of the hand associated with carpal tunnel syndrome.Carpal tunnel release(CTR)surgery may be a risk factor for trigger digit development;however,the association between surgical approach to CTR and postoperative trigger digit is equivocal.AIM To investigate patient risk factors for trigger digit development following either open carpal tunnel release(OCTR)or endoscopic carpal tunnel release(ECTR).METHODS This retrospective chart analysis evaluated 967 CTR procedures from 694 patients for the development of postoperative trigger digit.Patients were stratified according to the technique utilized for their CTR,either open or endoscopic.The development of postoperative trigger digit was evaluated at three time points:within 6 mo following CTR,between 6 mo and 12 mo following CTR,and after 12 mo following CTR.Firth’s penalized likelihood logistic regression was conducted to evaluate sociodemographic and patient comorbidities as potential independent risk factors for trigger digit.Secondary regression models were conducted within each surgical group to reveal any potential interaction effects between surgical approach and patient risk factors for the development of postoperative trigger digit.RESULTS A total of 47 hands developed postoperative trigger digit following 967 CTR procedures(4.9%).In total,64 digits experienced postoperative triggering.The long finger was most commonly affected.There was no significant difference between the open and endoscopic groups for trigger digit development at all three time points following CTR.Furthermore,there were no significant independent risk factors for postoperative trigger digit;however,within group analysis revealed a significant interaction effect between gender and surgical approach(P=0.008).Females were more likely to develop postoperative trigger digit than males after OCTR(OR=3.992),but were less likely to develop postoperative trigger digit than males after ECTR(OR=0.489).CONCLUSION Patient comorbidities do not influence the development of trigger digit following CTR.Markedly,gender differences for postoperative trigger digit may depend on surgical approach to CTR.
文摘BACKGROUND Trigger finger is a common disorder of the hand that can cause disabling symptoms.Treatment options range from conservative management with observation and splinting,to surgical release,but there is currently not a consensus on a treatment algorithm.AIM To determine patient preference for the treatment of trigger finger using an online survey.METHODS An online crowdsourcing platform,Amazon Mechanical Turk,was used to recruit participants for this study.Participants were led through a scenario in which they were diagnosed with trigger finger.They were then asked to rank their preference of treatment options from the following:Observation,splinting,corticosteroid injection,surgery.The results of the surveys were then analyzed using R software.RESULTS Of 323 participants completed the survey.7 participants were excluded because they failed to correctly answer the attention question,leaving 316 participants whose results were included.As a first choice for treatment 117(37%)of the included participants chose observation,86(27%)chose splinting,61(19%)chose corticosteroid injection,and 52(16%)chose surgery.The mean rank for observation was 2.26,for splinting was 2.30,for corticosteroid injection was 2.53,and for surgery was 2.91.The ranking of each treatment option was statistically different(P value<0.05)from the others except for observation and splinting.CONCLUSION The practice of shared decision making with patients is imperative to providing the best care possible.The results from this study,especially the preference for less invasive treatment,may help providers better frame discussion around treatment options of trigger fingers.This in turn,may increase patient satisfaction in the treatment of trigger finger.
