From the Hand Division, Department of Orthopaedic Surgery, Duke University Medical Center.
Plast Reconstr Surg. 2020 Oct;146(4):420e-427e. doi: 10.1097/PRS.0000000000007156.
The purpose of this study was to investigate the impact of diabetes on complications after open trigger finger release compared with a cohort matched for age, sex, race, and body mass index class.
A retrospective chart review was performed of diabetic patients who underwent trigger finger release at an academic institution within the past 10 years. Exclusion criteria included rheumatoid arthritis, malignancy, human immunodeficiency virus/acquired immunodeficiency syndrome, connective tissue disorders, or systemic steroid use. These patients were then matched by age, sex, race, and body mass index class to nondiabetic patients who underwent trigger finger release during the same period. One hundred thirty-seven patients met inclusion criteria and were matched with controls. Complications included superficial or deep infection, delayed wound healing, limited range of motion at 6 weeks, pain requiring medication at 6 weeks, and return to the operating room.
In adjusted analyses, diabetic patients had a significantly higher rate of all-cause complication following trigger finger release compared with matched nondiabetic controls at an odds ratio of 2.1. Diabetic patients also had a significantly higher rate of limitation in postoperative range of motion compared to the controls with an odds ratio of 2.4.
This retrospective case-control study identified that diabetic patients undergoing trigger finger release are at increased risk of all-cause postoperative complications and, specifically, range of motion limitation when compared with similar patients without diabetes.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.
本研究旨在探讨与年龄、性别、种族和体重指数匹配的队列相比，糖尿病对开放扳机指松解术后并发症的影响。
对过去 10 年在学术机构接受扳机指松解术的糖尿病患者进行回顾性图表审查。排除标准包括类风湿关节炎、恶性肿瘤、人类免疫缺陷病毒/获得性免疫缺陷综合征、结缔组织疾病或全身性类固醇使用。然后，这些患者按照年龄、性别、种族和体重指数与同期接受扳机指松解术的非糖尿病患者相匹配。符合纳入标准的 137 名患者与对照组相匹配。并发症包括浅表或深部感染、伤口愈合延迟、6 周时活动范围受限、6 周时需要药物治疗的疼痛以及返回手术室。
在调整后的分析中，与匹配的非糖尿病对照组相比，糖尿病患者在接受扳机指松解术后发生各种原因并发症的风险明显更高，优势比为 2.1。与对照组相比，糖尿病患者术后活动范围受限的风险也明显更高，优势比为 2.4。
这项回顾性病例对照研究表明，与没有糖尿病的类似患者相比，接受扳机指松解术的糖尿病患者术后发生各种原因并发症的风险增加，特别是活动范围受限的风险增加。
临床问题/证据水平：风险，II。
