Comparison of the Effectiveness of Percutaneous and Open Surgery in Trigger Finger Disease

Abstract

Introduction Trigger finger (TF) or stenosing tenosynovitis, first described by Alphonse Nota in 1850, has a lifetime prevalence of 2% to 3% in the adult population and an annual incidence of 28 per 100,000. Conservative treatment methods for TF include activity modification, orthotic immobilization, hand therapy exercise protocols, nonsteroidal anti-inflammatory drugs, and steroid injections. Surgical treatment involves releasing the A1 pulley by open or percutaneous surgery. Method: After receiving approval from the Health Sciences University Trabzon Faculty of Medicine Scientific Research Ethics Committee, 367 of 478 patients who underwent surgical treatment with the diagnosis of trigger finger in our clinic between 01.01.2018 and 01.01.2023 were included in our study. Patients were divided into open surgery and percutaneous surgery groups according to the surgical method applied. Preoperative trigger severity was evaluated according to Quinell's rating, pain was evaluated with the visual analog scale (VAS), and function was evaluated with the Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) score. Results There were significant differences in the preoperative VAS, postoperative VAS, first month VAS, sixth month VAS, and first year VAS scores between the open technique surgery group (p<0.001) and the percutaneous technique surgery group (p<0.001). Intergroup comparisons of Q-DASH scores revealedno significant differences in the preoperative (p=0.541), first month (p=0.231), sixth month (p=0.148), and first year (p=0.315) scores between the open and percutaneous surgery groups. Conclusions In our study, we found no significant differences in the results of the open and percutaneous surgery techniques we performed for the treatment of trigger finger disease. Several authors have reported differences between the results of open and percutaneous release techniques, while others have reported 100% success rates in grip strength, active range of motion of the proximal interphalangeal joint, and residual pain by both techniques.