Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Musculoskeletal Science and Translational Research Center, Chiang Mai University, Chiang Mai, Thailand; Clinical Epidemiology and Clinical Statistic Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Clinical Epidemiology and Clinical Statistic Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
J Plast Reconstr Aesthet Surg. 2023 Aug;83:352-357. doi: 10.1016/j.bjps.2023.05.008. Epub 2023 May 18.
Recurrent trigger finger after surgery is one of the major adverse events. However, studies to identify factors associated with recurrence after open surgical release in adult trigger finger patients are still limited.
To identify factors associated with recurrent trigger finger after open surgical release.
This 12-year retrospective observational study included 723 patients with 841 trigger fingers who underwent open A1 pulley release. Patients were categorized into 2 groups: those with recurrent trigger finger after surgery and those without. Associations between potential predictors including age, sex, duration of symptoms, occupation status, active smoker status, number of steroid injections before surgery, and types of comorbidities and the outcome of interest, recurrence of trigger finger, were examined using univariable and multivariable analyses. The results are presented as hazard ratios (HR) with a 95% confidence interval (95% CI).
The recurrence rate after trigger finger release was 2.39% (20 of 841 fingers). After adjusting for confounders, more than 3 steroid injections before surgery and manual labor were the independent predictors of recurrent trigger finger (HR = 4.87, 95%CI = 1.06-22.35 and HR = 3.43, 95%CI = 1.15-10.23, respectively).
More than 3 steroid injections before surgery and manual labor increase the risk of recurrent trigger finger after an open A1 pulley release. There may be limited benefit in administering a fourth steroid injection.
手术后复发性扳机指是主要的不良事件之一。然而，对于成人扳机指患者行开放手术松解后与复发相关的因素的研究仍然有限。
确定与开放手术松解后复发性扳机指相关的因素。
本研究为 12 年回顾性观察性研究，共纳入 723 例 841 指扳机指患者行开放 A1 滑车松解术。将患者分为两组：术后出现复发性扳机指和未出现复发性扳机指。使用单变量和多变量分析，检查包括年龄、性别、症状持续时间、职业状态、是否为主动吸烟者、术前皮质类固醇注射次数以及合并症类型等潜在预测因素与研究结局（即扳机指复发）之间的相关性。结果以风险比（HR）及其 95%置信区间（95%CI）表示。
扳机指松解术后的复发率为 2.39%（841 指中有 20 指）。校正混杂因素后，术前皮质类固醇注射超过 3 次和体力劳动是复发性扳机指的独立预测因素（HR=4.87，95%CI=1.06-22.35 和 HR=3.43，95%CI=1.15-10.23）。
术前皮质类固醇注射超过 3 次和体力劳动会增加开放 A1 滑车松解术后复发性扳机指的风险。第 4 次皮质类固醇注射可能获益有限。
