Factors associated with trigger digit following carpal tunnel release

Abstract

BACKGROUNDTrigger digit is a common disorder of the hand associated with carpal tunnel syndrome. Carpal tunnel release (CTR) surgery may be a risk factor for trigger digit development; however, the association between surgical approach to CTR and postoperative trigger digit is equivocal.AIMTo investigate patient risk factors for trigger digit development following either open carpal tunnel release (OCTR) or endoscopic carpal tunnel release (ECTR).METHODSThis retrospective chart analysis evaluated 967 CTR procedures from 694 patients for the development of postoperative trigger digit. Patients were stratified according to the technique utilized for their CTR, either open or endoscopic. The development of postoperative trigger digit was evaluated at three time points: within 6 mo following CTR, between 6 mo and 12 mo following CTR, and after 12 mo following CTR. Firth’s penalized likelihood logistic regression was conducted to evaluate sociodemographic and patient comorbidities as potential independent risk factors for trigger digit. Secondary regression models were conducted within each surgical group to reveal any potential interaction effects between surgical approach and patient risk factors for the development of postoperative trigger digit.RESULTSA total of 47 hands developed postoperative trigger digit following 967 CTR procedures (4.9%). In total, 64 digits experienced postoperative triggering. The long finger was most commonly affected. There was no significant difference between the open and endoscopic groups for trigger digit development at all three time points following CTR. Furthermore, there were no significant independent risk factors for postoperative trigger digit; however, within group analysis revealed a significant interaction effect between gender and surgical approach (P = 0.008). Females were more likely to develop postoperative trigger digit than males after OCTR(OR = 3.992), but were less likely to develop postoperative trigger digit than males after ECTR (OR = 0.489).CONCLUSIONPatient comorbidities do not influence the development of trigger digit following CTR. Markedly, gender differences for postoperative trigger digit may depend on surgical approach to CTR.

Carpal Tunnel Syndrome and Trigger Finger. Sometimes Related

“…Endoscopic carpal tunnel release was an independent risk factor for the trigger finger. This contrasts with Nosewicz et al [12] and Harada et al [18], who found endoscopic carpal tunnel release was not a risk factor. Shafee-Khanghah et al [14] retrospectively reviewed 57 consecutive patients who underwent trigger finger release surgery and found that 15 (26.3%) had undergone prior carpal tunnel release surgery approximately 6 months before trigger finger release.…”

“…Nosewicz et al [12] performed a retrospective chart analysis of 967 carpal tunnel release procedures (open or endoscopic) in 694 patients. 64 trigger digits were seen postoperatively in 47 hands (4.9%).…”

High incidence of trigger finger after carpal tunnel release: a systematic review and meta-analysis

“…For the incidence of post-CTR TF, a sample size of 9207 was included in the final analysis. The data of post-CTR TF were provided as number of people in five studies 16 – 18 , 21 , 22 and number of hands in five studies 15 , 19 , 20 , 23 , 24 . Four studies 17 , 18 , 23 , 24 were conducted in the United States, four in Asia (two in Japan 19 , 20 , one in Korea 21 , one in Taiwan 22 ), and two in Europe (one in Turkey 15 and one in Spain 16 ).…”

“…The data of post-CTR TF were provided as number of people in five studies 16 – 18 , 21 , 22 and number of hands in five studies 15 , 19 , 20 , 23 , 24 . Four studies 17 , 18 , 23 , 24 were conducted in the United States, four in Asia (two in Japan 19 , 20 , one in Korea 21 , one in Taiwan 22 ), and two in Europe (one in Turkey 15 and one in Spain 16 ). For subgroup analysis of patients with and without post-CTR TF, three studies 16 , 17 , 21 provide the number of men and women; three 16 , 17 , 21 provided data on the patients’ mean age; and three 17 , 18 , 21 reported the number of patients with DM.…”

“…Seven studies 15 – 20 , 23 were pooled to calculate the prevalence of the post-CTR TF on the affected digits. The thumb was most commonly involved (31.44%), followed by the middle, ring, index, and little fingers (22.26%, 20.04%, 9.26%, and 9.10%, respectively), with the thumb having the highest risk of post-CTR TF (95% CI: 0.277–0.441, P =0.001; I 2 =73.23%, P =0.001; Fig.…”