Nathan G Everding1, Gavin B Bishop1, Christopher M Belyea2, Maximillian C Soong3. 1. Boston University Orthopaedic Surgery Residency, 725 Albany Street 4B, Boston, MA 02118 USA. 2. Tufts University School of Medicine, 145 Harrison Avenue, Boston, MA 02111 USA. 3. Lahey Clinic, 41 Mall Road, Burlington, MA 01805 USA.
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 low-risk 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.
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 low-risk 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.
Entities:
Keywords:
Complications; Open release; Trigger finger
Authors: Leilani Morales; Steven Pans; Robert Paridaens; Rene Westhovens; Dirk Timmerman; Johan Verhaeghe; Hans Wildiers; Karin Leunen; Frederic Amant; Patrick Berteloot; Ann Smeets; Erik Van Limbergen; Caroline Weltens; Walter Van den Bogaert; Luc De Smet; Ignace Vergote; Marie-Rose Christiaens; Patrick Neven Journal: Breast Cancer Res Treat Date: 2006-10-24 Impact factor: 4.872