Gehring Michael B, Constantine Ryan S, Le Elliot L H, Wolfe Brandon, Greyson Mark A, Iorio Matthew L
From the Division of Plastic and Reconstructive Surgery, University of Colorado Anschutz Medical Center, Aurora, Col.
Plast Reconstr Surg Glob Open. 2023 Jun 12;11(6):e5063. doi: 10.1097/GOX.0000000000005063. eCollection 2023 Jun.
Dupuytren disease is associated with inflammation and myofibroblast overgrowth, as is stenosing tenosynovitis (trigger finger). Both are linked with fibroblast proliferation, but a potential associative link between the diseases is unknown. The purpose of this study was to evaluate the progression of trigger finger following treatment for Dupuytren contracture in a large database.
A commercial database encompassing 53 million patients was utilized from January 1, 2010 to March 31, 2020. The study cohort included patients diagnosed with either Dupuytren disease or trigger finger utilizing International Classification Codes 9 and 10. Terminology codes were used to identify common Dupuytren procedures, as well as trigger finger release. Logistic regression analysis was used to define independent risk factors for developing trigger finger.
A total of 593,606 patients were diagnosed with trigger finger. Of these patients, 15,416 (2.6%) were diagnosed with trigger finger after diagnosis of Dupuytren disease, whereas 2603 (0.4%) patients were diagnosed with trigger finger after treatment of Dupuytren contracture. Independent risk factors for trigger finger included age 65 years or older (OR 1.00, < 0.05), diabetes (OR 1.12, < 0.05) and obesity (OR 1.20, < 0.005). Patients who received collagenase clostridium histolyticum treatment (OR 0.34, < 0.005) for Dupuytren contracture were significantly less likely to develop trigger finger.
Dupuytren contracture is associated with inflammation and subsequent trigger finger development at a higher rate than the background population frequency. Collagenase clostridium histolyticum injection may lead to a decreased risk of trigger finger requiring surgical intervention in patients with risk factors.
掌腱膜挛缩症与炎症及肌成纤维细胞过度生长有关,狭窄性腱鞘炎(扳机指)也是如此。两者均与成纤维细胞增殖有关,但这两种疾病之间潜在的关联尚不清楚。本研究的目的是在一个大型数据库中评估掌腱膜挛缩症治疗后扳机指的进展情况。
使用了一个涵盖5300万患者的商业数据库,时间跨度为2010年1月1日至2020年3月31日。研究队列包括使用国际疾病分类代码9和10诊断为掌腱膜挛缩症或扳机指的患者。术语代码用于识别常见的掌腱膜挛缩症手术以及扳机指松解术。采用逻辑回归分析来确定发生扳机指的独立危险因素。
共有593606例患者被诊断为扳机指。在这些患者中,15416例(2.6%)在诊断掌腱膜挛缩症后被诊断为扳机指,而2603例(0.4%)患者在掌腱膜挛缩症治疗后被诊断为扳机指。扳机指的独立危险因素包括65岁及以上年龄(比值比1.00,<0.05)、糖尿病(比值比1.12,<0.05)和肥胖(比值比1.20,<0.005)。接受溶组织梭状芽孢杆菌胶原酶治疗掌腱膜挛缩症的患者(比值比0.34,<0.005)发生扳机指的可能性显著降低。
掌腱膜挛缩症与炎症及随后扳机指的发生有关,其发生率高于背景人群频率。注射溶组织梭状芽孢杆菌胶原酶可能会降低有危险因素的患者需要手术干预的扳机指风险。