North Shore Surgi-Center, Smithtown, NY, USA.
Mirza Orthopedics, Smithtown, NY, USA.
Hand (N Y). 2023 Oct;18(7):1089-1094. doi: 10.1177/15589447221081869. Epub 2022 Mar 30.
Open trigger finger release (OTFR) and endoscopic trigger finger release (ETFR) are effective methods in treating stenosing tenosynovitis. However, a paucity of literature exists comparing the techniques. This study describes and compares postoperative complications following OTFR and ETFR at a single institution.
Patients undergoing trigger finger release between 2018 and 2020 within a single institution were identified. Electronic medical records were reviewed for patient demographics, surgical history, surgical characteristics, and clinical outcomes. Major and minor postoperative complications were assessed. Secondary outcome measures included tourniquet time and procedure time. Statistical analysis evaluated associations between postoperative complications, surgical technique, patient demographics, and surgical characteristics.
In total, 57 patients (80 digits) were included in the study: 42 digits treated with OTFR and 38 digits treated with ETFR. Mean follow-up time was 57.6 ± 69.0 days (range, 7-307 days) for ETFR and 34.2 ± 26.3 days (range, 6-120 days) for OTFR. Overall, major, and minor complication rates for the cohort were 8.8%, 1.8% and 7.0%, respectively. There were no major complications following ETFR and 1 following OTFR (4%), the isolated case being postoperative Chronic regional pain syndrome. Minor complication rates were similar following OTFR (8%) and ETFR (6%). Persistent digit stiffness and swelling were found to be the most prevalent minor complications (n = 2, respectively), followed by wound dehiscence (n = 1). Female patients were significantly more likely to experience postoperative complications.
Major complications following trigger finger release are unlikely; however, minor complications are prominent. Patients treated with OTFR and ETFR showed similar postoperative complication rates. Continued investigations into the benefits of ETFR are warranted.
开放式扳机指松解术（OTFR）和内镜下扳机指松解术（ETFR）是治疗狭窄性腱鞘炎的有效方法。然而，目前比较这两种技术的文献很少。本研究描述并比较了单一机构中 OTFR 和 ETFR 术后并发症。
在一家机构中，确定了在 2018 年至 2020 年间接受扳机指松解术的患者。回顾电子病历，以获取患者人口统计学、手术史、手术特点和临床结果。评估主要和次要术后并发症。次要结果包括止血带时间和手术时间。统计分析评估了术后并发症、手术技术、患者人口统计学和手术特点之间的关联。
共有 57 名患者（80 个手指）纳入本研究：42 个手指接受 OTFR 治疗，38 个手指接受 ETFR 治疗。ETFR 的平均随访时间为 57.6±69.0 天（范围，7-307 天），OTFR 的平均随访时间为 34.2±26.3 天（范围，6-120 天）。总的来说，该队列的主要、次要并发症发生率分别为 8.8%、1.8%和 7.0%。ETFR 组无主要并发症，OTFR 组有 1 例（4%），孤立病例为术后慢性区域性疼痛综合征。OTFR（8%）和 ETFR（6%）的次要并发症发生率相似。最常见的轻微并发症是持续性手指僵硬和肿胀（分别为 n=2），其次是伤口裂开（n=1）。女性患者发生术后并发症的可能性明显更高。
扳机指松解术后发生主要并发症的可能性不大，但轻微并发症较为突出。接受 OTFR 和 ETFR 治疗的患者术后并发症发生率相似。有必要进一步研究 ETFR 的益处。
