The present paper aims to evaluate the therapeutic planning for trigger finger by Brazilian orthopedists. This is a cross-sectional study with a population composed of participants from the 2018 Brazilian Congress on Orthopedics and Traumatology (CBOT-2018, in the Portuguese acronym), who answered a questionnaire about the conduct adopted for trigger finger diagnosis and treatment. A total of 243 participants were analyzed, with an average age of 37.46 years old; most participants were male (88%), with at least 1 year of experience (55.6%) and from Southeast Brazil (68.3%). Questionnaire analysis revealed a consensus on the following issues: diagnosis based on physical examination alone (73.3%), use of the Quinnell classification modified by Green (58.4%), initial nonsurgical treatment (91.4%), infiltration of steroids combined with an anesthetic agent (61.7%), nonsurgical treatment time ranging from 1 to 3 months (52.3%), surgical treatment using the open approach (84.4%), mainly the transverse open approach (51%), triggering recurrence as the main nonsurgical complication (58%), and open surgery success in > 90% of the cases (63%), with healing intercurrences (54%) as the main complication. There was no consensus on the remaining variables. Orthopedists with different practicing times disagree on treatment duration ( = 0.013) and on the complication rate of open surgery ( = 0.010). Brazilian orthopedists prefer to diagnose trigger finger with physical examination alone, to classify it according to the Quinnell method modified by Green, to institute an initial nonsurgical treatment, to perform infiltrations with steroids and local anesthetic agents, to sustain the nonsurgical treatment for 1 to 3 months, and to perform the surgical treatment using a transverse open approach; in addition, they state that the main nonsurgical complication was triggering recurrence, and report open surgery success in > 90% of the cases, with healing intercurrences as the main complication.
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http://dx.doi.org/10.1055/s-0040-1721363 | DOI Listing |
J Hand Microsurg
January 2025
Department of Orthopaedic Surgery, University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
Background: Trigger finger is a common disorder of the hand characterized by pain and locking of the digits during flexion or extension. In cases refractory to nonoperative management, surgical release of the A1 pulley can be performed. This study evaluates the ability of machine learning (ML) techniques to predict short-term complications following trigger digit release surgery.
View Article and Find Full Text PDFJ Hand Surg Eur Vol
January 2025
Hand Surgery Unit, Department of Orthopedic Surgery, Assuta-Ashdod University Hospital, Ashdod 7747629, Israel.
The impact of preoperative structured instructions by a hand therapist on recovery after carpal tunnel and trigger finger releases was assessed in 87 patients. No significant differences in recovery, satisfaction, or outcomes were found, suggesting limited benefit.
View Article and Find Full Text PDFJ Pers Med
December 2024
Department of Orthopaedics and Traumatology, Universita' Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168 Rome, Italy.
: The Wide Awake Local Anesthesia No Tourniquet (WALANT) technique has revolutionized outpatient hand surgery, enabling procedures such as carpal tunnel release and trigger finger release without a tourniquet. Its benefits include patient cooperation during surgery, especially for tendon repairs. However, WALANT has limitations, including a steep learning curve, longer operative preparation time, and risks such as digital ischemia and adrenaline-induced cardiac ischemia.
View Article and Find Full Text PDFBackground: While concomitant opioid and benzodiazepine use is discouraged due to an increased risk of sedation/overdose, the extent of perioperative opioid utilization in hand surgery patients already using benzodiazepines is unknown.
Methods: Using an administrative claims database, we identified adults undergoing carpal tunnel, DeQuervain, or trigger finger release, palmar fasciectomies, ganglion/mucoid cyst removals, and hand/wrist soft tissue mass excisions from 2011 to 2021. We identified opioid-naive patients with a benzodiazepine prescription within 90 days before surgery.
Hand Surg Rehabil
January 2025
Orthopedic Surgery Department, CHU Caremeaux, Nîmes, France.
The purpose of this study was to evaluate the results of a novel retrograde ultrasound-guided A1 pulley release technique for the treatment of trigger thumb. We conducted a retrospective, single-center study of 42 patients who underwent ultrasound-guided A1 pulley release for clinically diagnosed trigger thumb between September 2022 and December 2023. All cases were graded according to the Green classification of trigger finger severity.
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