Factors affecting prognosis in open A1 pulley release surgery for trigger finger

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Musculoskeletal Disorders

Background:

• Trigger finger, a common condition, often requires surgical intervention like A1 pulley release.
• Open A1 pulley release is a standard procedure, but recurrence and prolonged postoperative symptoms can occur.
• Factors influencing outcomes after trigger finger surgery require further investigation.

Purpose of the Study:

• To determine the frequency of recurrence and prolonged postoperative symptoms following open A1 pulley release for trigger finger.
• To identify factors associated with prolonged symptoms and functional recovery after surgery.
• To evaluate the impact of loupe magnification on surgical outcomes.

Main Methods:

• Retrospective analysis of 72 patients undergoing open A1 pulley release for trigger finger between October 2021 and December 2023.
• Data collected included demographics, comorbidities, clinical scores (Quinnell, DASH), grip strength, and surgeon experience.
• Prolonged symptoms (lasting >8 weeks) and outcomes were assessed, with a focus on loupe usage.

Main Results:

• Loupe-assisted surgeries showed significantly lower rates of prolonged symptoms (12.50% vs. 35.00%, p=0.028).
• Mean Disabilities of the Arm, Shoulder and Hand (DASH) scores significantly improved post-surgery, with greater improvement in the loupe group.
• Grip strength was maintained on the surgical side in the loupe group but was weaker in the non-loupe group.

Conclusions:

• Loupe magnification in open A1 pulley release for trigger finger is associated with reduced prolonged postoperative symptoms.
• Loupe-assisted procedures may lead to improved functional outcomes and grip strength recovery.
• The use of loupes should be considered to enhance patient outcomes in trigger finger surgery.