Comparative outcomes of single versus multiple trigger finger releases: a propensity score matched cohort study

Trigger finger (TF) release is one of the most common procedures in hand surgery. It is not clear whether outcomes differ when multiple digits are released in the same operating session. The present study aimed to compare outcomes between patients undergoing single digit and multiple digit TF release.

We conducted a retrospective cohort study using the TriNetX database (https://trinetx.com/) to identify patients undergoing trigger finger release between 2010 and 2025. Patients were categorized into single digit and multiple digit release groups. Postoperative complications within 90 days, as defined by International Classification of Diseases, 10th revision codes, including hand pain, stiffness, haematoma, delayed wound healing and need for flexor tenolysis, were assessed. To minimize confounding, cohorts were balanced using 1:1 propensity score matching for demographics and comorbidities.

A total of 119,306 patients undergoing trigger finger release were identified. After 1:1 propensity score matching, 48,840 patients were included in each cohort with well-balanced baseline demographics and comorbidities. Compared with single-digit release, multiple-digit release was associated with significantly higher rates of postoperative pain (1.92% vs. 1.00%; RR 1.92; 95% CI: 1.72 to 2.14; p < 0.001), joint stiffness or contracture (6.82% vs. 3.03%; RR 2.25; 95% CI: 2.12 to 2.39; p < 0.001), and subsequent flexor tenolysis (1.06% vs. 0.80%; RR 1.32; 95% CI: 1.16 to 1.51; p < 0.001). Complex regional pain syndrome was rare and observed only in the multiple-digit cohort (0.04%).

Multiple-digit trigger finger release in a single operative session is associated with higher rates of postoperative pain, joint stiffness and need for flexor tenolysis compared with single-digit release, even after adjustment for demographics and comorbidities.

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