Recurrent Diabetic Trigger Finger. Percutaneous or Open Release as Surgical Treatment is More Effective in Long-term Outcomes?

In diabetic patients, stenosing tenosynovitis is a common complication. The final treatment is the release of the A1 pulley (open or percutaneous). This research compares the functional outcomes and complication rates of two approaches for recurrent trigger finger in diabetic patients (open versus percutaneous release).

Materials and Methods: Chronic trigger finger was treated in 114 diabetic patients with an average age of 48 years (range 28-64 years). For the classification of trigger digits, the updated Quinnell grading system was used as a selection criterion. The patients were randomly divided into two groups. Patients in Group A were treated with open A1 pulley release, while patients in Group B were treated with percutaneous release using the tip of an 18-gauge or knife (Ophtalmic Corneal/ Scleral knife 19 Gauge).

The average period of follow-up was 12 months (range from 10-14 months). The Visual Analogue Scale (VAS), Fast Dash, and Gilberts & Wereldasma Questionnaire were used to determine the results. The findings seemed to be higher in group B at three months, but there was no statistical difference at six months or one year after surgery.

Conclusions: Both surgical methods (open and percutaneous release) produced comparable therapeutic efficacy in long-term postoperative follow-up. In terms of short-term results, the percutaneous release has the following advantages over the traditional open method: 1) low cost, 2) lower complication rates, and 3) rapid functional recovery.

Author (s) Details

G. Kastanis
Department of Orthopaedic, General Hospital of Heraklion –Venizeleio, Crete, Greece.

A. Pantouvaki
Department of Physiotherapy, General Hospital of Heraklion –Venizeleio, Crete, Greece.

P. Kapsetakis
Department of Orthopaedic, General Hospital of Heraklion –Venizeleio, Crete, Greece.

C. Christoforidis
Department of Orthopaedic, General Hospital of Heraklion –Venizeleio, Crete, Greece.

C. Chaniotakis
Department of Orthopaedic, General Hospital of Heraklion –Venizeleio, Crete, Greece.

G. Magarakis
Department of Orthopaedic, General Hospital of Heraklion –Venizeleio, Crete, Greece.

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