Bezirgan Uğur, Bekar Hasan, Dursun Savran Merve, Yoğun Yener, Armangil Mehmet
Ankara Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, 06230 Altındağ, Ankara, Türkiye.
Jt Dis Relat Surg. 2025 Jan 2;36(1):78-84. doi: 10.52312/jdrs.2024.1885. Epub 2024 Dec 10.
This study aims to investigate the frequency of recurrence and prolonged postoperative symptoms in patients undergoing open A1 pulley release for trigger finger and to identify potential associated factors.
Between October 2021 and December 2023, a total of 72 patients (30 males, 42 females; mean age: 58.0±11.6 years; range, 32 to 84 years) who underwent trigger finger surgery with at least six months of follow-up were retrospectively analyzed. Patients were followed prospectively and relevant data were collected from patient files retrospectively. Demographics, finger symptoms, associated pathologies, clinical grades, Quinnell scores, Disabilities of the Arm, Shoulder and Hand (DASH) scores, grip strength, and surgeon experience were evaluated. Prolonged symptoms lasting over eight weeks postoperatively were also assessed.
Comorbidities included carpal tunnel syndrome (13.89%), De Quervain tenosynovitis (13.89%), diabetes (8.33%), Bouchard's node (2.78%), ganglion cyst (8.33%), and calcium deposition (2.86%). Fourteen patients (19.44%) had additional trigger fingers. Loupe was used in 32 surgeries, resulting in significantly fewer prolonged symptoms (12.50% vs. 35.00%, p=0.028). The mean DASH scores significantly improved after surgery (53.07±13.43 vs. 18.41±11.26, p=0.000), with a greater improvement in the loupe group (46.52±6.50 vs. 25.18±13.96, p=0.0000). The mean grip strength did not significantly differ between the surgical and control sides in the loupe group (27.29±7.58 vs. 26.36±7.85 lb, p=0.0887); however, it was weaker on the surgical side in the nonloupe group (23.87±7.81 vs. 25.28±6.96 lb, p=0.0067). Loupe usage was the sole significant factor which was absent in 77.78% of the patients with prolonged symptoms.
Trigger finger surgery, though typically simple and routine, may benefit from loupe-assisted procedures due to reduced postoperative symptoms and improved functional outcomes. Consideration of loupe use is warranted in such surgeries.
本研究旨在调查接受扳机指开放性A1滑车松解术患者的复发频率和术后症状延长情况，并确定潜在的相关因素。
回顾性分析2021年10月至2023年12月期间共72例接受扳机指手术且随访至少6个月的患者（30例男性，42例女性；平均年龄：58.0±11.6岁；范围32至84岁）。对患者进行前瞻性随访，并从患者病历中回顾性收集相关数据。评估人口统计学、手指症状、相关病理、临床分级、奎内尔评分、手臂、肩部和手部功能障碍（DASH）评分、握力和外科医生经验。还评估了术后持续超过8周的延长症状。
合并症包括腕管综合征（13.89%）、桡骨茎突狭窄性腱鞘炎（13.89%）、糖尿病（8.33%）、布夏尔结节（2.78%）、腱鞘囊肿（8.33%）和钙沉积（2.86%）。14例患者（19.44%）有额外的扳机指。32例手术使用了放大镜，术后症状延长的情况明显较少（12.50%对35.00%，p=0.028）。术后平均DASH评分显著改善（53.07±13.43对18.41±11.26，p=0.000），放大镜组改善更大（46.52±6.50对25.18±13.96，p=0.0000）。放大镜组手术侧与对照侧的平均握力无显著差异（27.29±7.58对26.36±7.85磅，p=0.0887）；然而，非放大镜组手术侧的握力较弱（23.87±7.81对25.28±6.96磅，p=0.0067）。使用放大镜是术后症状延长患者中77.78%不存在的唯一显著因素。
扳机指手术虽然通常简单且常规，但由于术后症状减轻和功能结果改善，可能受益于放大镜辅助手术。在这类手术中值得考虑使用放大镜。
