Hsieh Hsin-Han, Wu Wen-Tien, Shih Jui-Tien, Wang Jen-Hung, Yeh Kuang-Ting
School of Medicine, Tzu Chi University, Hualien, Taiwan.
Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Clin Epidemiol. 2022 Sep 29;14:1079-1086. doi: 10.2147/CLEP.S383397. eCollection 2022.
The correlation between carpal tunnel syndrome (CTS) surgery and trigger finger (TF) surgery is unclear; we conducted this nationwide population-based study to assess the development of severe CTS requiring surgery after TF surgery.
This retrospective cohort study used the data of patients diagnosed as having TF between January 1, 2001, and December 31, 2017, and they were divided into two comparative groups. Patients who underwent surgical release within 1 year of diagnosis were included in the TF-OP group, and those who did not undergo TF release during the same period were included in the TF-NOP group. The primary outcome was the new incidence of CTS release (CTR), and data on the related risk factors were collected for analysis.
A total of 8232 patients each were enrolled into the TF-OP and TF-NOP groups and were 1:1 propensity score matched (mean patient age, 54.7 ± 10.1 years; mean follow-up duration, 6.58 years). The incidence rate of CTR was 1.1 per 1000 person-years in the TF-OP group and 0.7 per 1000 person-years in the TF-NOP group. The adjusted hazard ratio of TF surgery was 1.51. The factors significantly correlated with an increased incidence of CTR were age, female sex, diabetes mellitus, and chronic renal failure. In subgroup analysis, patients aged >65 years and female patients in the TF-OP group were still at significantly higher risks of CTR than were their counterparts in the TF-NOP subgroups. The cumulative incidence of CTR after TF surgery linearly increased with time in both groups.
Patients undergoing TF release may have a higher incidence of CTR 1 year later, especially women and patients aged >65 years. Diabetes mellitus and chronic renal failure may be risk factors.
腕管综合征(CTS)手术与扳机指(TF)手术之间的相关性尚不清楚;我们开展了这项基于全国人群的研究,以评估TF手术后需要手术治疗的严重CTS的发生情况。
这项回顾性队列研究使用了2001年1月1日至2017年12月31日期间被诊断为患有TF的患者数据,并将他们分为两个比较组。在诊断后1年内接受手术松解的患者被纳入TF-OP组,同期未接受TF松解的患者被纳入TF-NOP组。主要结局是CTS松解术(CTR)的新发发生率,并收集相关危险因素的数据进行分析。
TF-OP组和TF-NOP组各纳入8232例患者,且按1:1倾向评分匹配(患者平均年龄54.7±10.1岁;平均随访时间6.58年)。TF-OP组CTR的发生率为每1000人年1.1例,TF-NOP组为每1000人年0.7例。TF手术的调整后风险比为1.51。与CTR发生率增加显著相关的因素是年龄、女性、糖尿病和慢性肾衰竭。在亚组分析中,TF-OP组中年龄>65岁的患者和女性患者发生CTR的风险仍显著高于TF-NOP亚组中的对应患者。两组中TF手术后CTR的累积发生率均随时间呈线性增加。
接受TF松解术的患者在1年后发生CTR的发生率可能更高,尤其是女性和年龄>65岁的患者。糖尿病和慢性肾衰竭可能是危险因素。