HbA1c Levels Do Not Affect Long-Term Outcome After Open Trigger Finger Release in Individuals With Diabetes Mellitus

Trigger finger surgery typically has a successful outcome, also in patients with diabetes mellitus (DM). However, the impact of glycemic control on long-term outcomes after open trigger finger release (OTFR) remains unclear. This study examines whether high hemoglobin A1c (HbA1c) levels affect patient-reported outcome (PRO) following OTFR in individuals with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM).

Data from 2010 to 2020 were sourced from the Swedish national quality register for hand surgery (HAKIR) and cross-linked with the Swedish National Diabetes Register. Adults ≥18 years undergoing OTFR were included. Patient-reported outcomes were assessed using the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) and HAKIR Questionnaire-8 (HQ-8) questionnaires (evaluating stiffness, pain, and satisfaction) preoperatively and at 3 and 12 months postsurgery. Participants were stratified into tertiles based on mean HbA1c: "optimal control" (≤48 mmol/mol), "acceptable control" (48.1-64 mmol/mol), and "poor control" (>64 mmol/mol). Linear mixed model regression, adjusted for sex, age, DM duration, smoking, mean arterial pressure, body mass index, and physical activity, analyzed outcomes over time, using "acceptable control" group as reference. To adjust for multiple comparisons, a Bonferroni correction was used.

In total, 496 individuals with T1DM and 869 individuals with T2DM underwent OTFR and were registered in HAKIR. Of these, 53% (n = 710) answered at least 1 questionnaire. There was no difference in QuickDASH nor the studied HQ-8 between the different HbA1c groups at 12 months, neither in individuals with T1DM nor T2DM.

Poor glycemic control was not associated with worse PRO 12 months after OTFR. Thus, for long-term outcome, preoperative HbA1c testing does not seem to be necessary.