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Primary Negative Prognostic Factors in Pediatric and Adult Patients Undergoing Trigger Finger Surgery
Muhammed Köroğlu1, Mustafa Karakaplan1, Mustafa Yıldız1
1Orthopaedics and Traumatology, İnönü University School of Medicine, Malatya, TUR.
Insights
For adults with trigger finger, higher Green stage and longer symptom duration before surgery indicate poorer outcomes. Pediatric patients do not show these negative prognostic indicators.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Musculoskeletal Disorders
Background:
- Trigger finger, a common condition affecting hand function, presents differently in pediatric and adult populations.
- Identifying negative prognostic indicators is crucial for managing patient expectations and optimizing surgical outcomes.
Purpose of the Study:
- To investigate factors predicting complications, recurrence, and satisfaction after trigger finger surgery in pediatric and adult patients.
- To differentiate prognostic indicators between pediatric and adult trigger finger surgery outcomes.
Main Methods:
- Retrospective study of 61 patients (91 trigger fingers), including 31 pediatric and 30 adult cases.
- Standardized surgical technique with analysis of demographic, clinical factors, and patient-reported outcomes (QDASH, VAS).
- Evaluation of Green classification, symptom duration, comorbidities, and surgical history as prognostic indicators.
Main Results:
- In adults, higher Green stage and longer pre-surgery symptom duration correlated with increased complications, recurrence, and lower satisfaction.
- Pediatric patients did not show significant correlations between Green's classification or symptom duration and outcomes.
- Longer interval from clinic initiation to surgery was linked to complications in adults but not in pediatric patients.
Conclusions:
- Green stage and symptom duration are significant negative prognostic indicators for adult trigger finger surgery.
- These factors do not appear to influence outcomes in pediatric trigger finger cases.
- Findings aid physicians in treatment management and setting patient expectations for improved satisfaction.
Abstract:
Objectives This study aims to investigate the negative prognostic indicators of pediatric and adult trigger finger surgery patients concerning complications, recurrence, and satisfaction. Methods A retrospective study was conducted on 61 patients with a total of 91 trigger fingers, including 31 in children and 30 in adult patients, all of whom were treated using a standardized surgical technique. The study considered several demographic and clinical factors, including age, gender, dominant hand, body mass index, occupation, history of trauma, single or multiple finger involvement, staging according to Green classification, diabetes mellitus, comorbidities, recurrence, revision surgery, utilization of non-surgical treatment methods, need for rehabilitation after surgery, time to return to work, the time interval from clinic initiation to the surgery, satisfaction and the duration of the follow-up period. In addition, the quick version of the disabilities of the arm, shoulder, and hand (QDASH); and the visual analog scale (VAS) were used to assess patients' data. Results In adult patients, a statistically significant relationship was observed between the increasing grade of the Green stage and complication rate (p<0.001), recurrence (p<0.001), and lower satisfaction (p<0.001). No statistically significant relationship was identified between Green's classification and complications (p=0.129), recurrence (p=0.854), or satisfaction (p=0.143) in pediatric patients. While a statistically significant relationship existed between the time interval from clinic initiation to surgery and complications (p=0.033) in adult patients, no significant relationships were observed for recurrence or satisfaction. Conversely, there was no statistically significant relationship between the time interval from clinic initiation to surgery and complications, recurrence, or satisfaction in pediatric patients. Conclusion This study demonstrates that increasing the grade of the Green stage and duration of symptoms before surgery were the substantial factors contributing to prognosis in adult patients but not in pediatric patients. These findings can assist physicians during patients' treatment management. We suggest that physicians consider these factors for patients' satisfaction.
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