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Nonpalmar Endoscopic versus Open Trigger Finger Release: Results from a Prospective Trial

The most common complaint after open surgical release for trigger finger is of pain and scarring at the surgical site. We hypothesized that use of a new nonpalmar endoscopic approach for release of the A1 pulley through an incision at the proximal digital crease would result in decreased scarring an...

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Autores principales: Brown, Ashley M., Tanabe, Kylie L., DellaMaggiora, Ryan J., Tsai, Eugene Y., Kuschner, Stuart H., Kulber, David A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9542749/
https://www.ncbi.nlm.nih.gov/pubmed/36225845
http://dx.doi.org/10.1097/GOX.0000000000004603
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author Brown, Ashley M.
Tanabe, Kylie L.
DellaMaggiora, Ryan J.
Tsai, Eugene Y.
Kuschner, Stuart H.
Kulber, David A.
author_facet Brown, Ashley M.
Tanabe, Kylie L.
DellaMaggiora, Ryan J.
Tsai, Eugene Y.
Kuschner, Stuart H.
Kulber, David A.
author_sort Brown, Ashley M.
collection PubMed
description The most common complaint after open surgical release for trigger finger is of pain and scarring at the surgical site. We hypothesized that use of a new nonpalmar endoscopic approach for release of the A1 pulley through an incision at the proximal digital crease would result in decreased scarring and faster recovery compared to those treated with standard open release. METHODS: Patients with trigger finger were prospectively enrolled and treated with a nonpalmar endoscopic versus open surgical technique. Outcome measures included scar assessment based on the Patient and Observer Scar Assessment Scale (POSAS) administered 1 week, 1 month, and 6 months postoperatively, time before return to work, occupational therapy visits, and overall satisfaction. Additional outcomes included pain medication use, operative time, and complication and recurrence rates. RESULTS: POSAS scores were better in the endoscopic treatment group than in the open group at all time points with a statistically significant difference seen at 1 week and 1 month postoperatively. The endoscopic group returned to work sooner, required fewer occupational therapy visits, and had better overall satisfaction compared to the open group, but the differences were not statistically significant. Complication and recurrence rates did not differ significantly between groups. CONCLUSIONS: Patients treated for trigger finger with a nonpalmar endoscopic release through an incision at the proximal digital crease demonstrate significantly better scarring in the early postoperative period compared to patients treated with the open surgical approach. Treatment for trigger finger with this technique is as effective as the standard open technique.
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spelling pubmed-95427492022-10-11 Nonpalmar Endoscopic versus Open Trigger Finger Release: Results from a Prospective Trial Brown, Ashley M. Tanabe, Kylie L. DellaMaggiora, Ryan J. Tsai, Eugene Y. Kuschner, Stuart H. Kulber, David A. Plast Reconstr Surg Glob Open Hand The most common complaint after open surgical release for trigger finger is of pain and scarring at the surgical site. We hypothesized that use of a new nonpalmar endoscopic approach for release of the A1 pulley through an incision at the proximal digital crease would result in decreased scarring and faster recovery compared to those treated with standard open release. METHODS: Patients with trigger finger were prospectively enrolled and treated with a nonpalmar endoscopic versus open surgical technique. Outcome measures included scar assessment based on the Patient and Observer Scar Assessment Scale (POSAS) administered 1 week, 1 month, and 6 months postoperatively, time before return to work, occupational therapy visits, and overall satisfaction. Additional outcomes included pain medication use, operative time, and complication and recurrence rates. RESULTS: POSAS scores were better in the endoscopic treatment group than in the open group at all time points with a statistically significant difference seen at 1 week and 1 month postoperatively. The endoscopic group returned to work sooner, required fewer occupational therapy visits, and had better overall satisfaction compared to the open group, but the differences were not statistically significant. Complication and recurrence rates did not differ significantly between groups. CONCLUSIONS: Patients treated for trigger finger with a nonpalmar endoscopic release through an incision at the proximal digital crease demonstrate significantly better scarring in the early postoperative period compared to patients treated with the open surgical approach. Treatment for trigger finger with this technique is as effective as the standard open technique. Lippincott Williams & Wilkins 2022-10-07 /pmc/articles/PMC9542749/ /pubmed/36225845 http://dx.doi.org/10.1097/GOX.0000000000004603 Text en Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Hand
Brown, Ashley M.
Tanabe, Kylie L.
DellaMaggiora, Ryan J.
Tsai, Eugene Y.
Kuschner, Stuart H.
Kulber, David A.
Nonpalmar Endoscopic versus Open Trigger Finger Release: Results from a Prospective Trial
title Nonpalmar Endoscopic versus Open Trigger Finger Release: Results from a Prospective Trial
title_full Nonpalmar Endoscopic versus Open Trigger Finger Release: Results from a Prospective Trial
title_fullStr Nonpalmar Endoscopic versus Open Trigger Finger Release: Results from a Prospective Trial
title_full_unstemmed Nonpalmar Endoscopic versus Open Trigger Finger Release: Results from a Prospective Trial
title_short Nonpalmar Endoscopic versus Open Trigger Finger Release: Results from a Prospective Trial
title_sort nonpalmar endoscopic versus open trigger finger release: results from a prospective trial
topic Hand
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9542749/
https://www.ncbi.nlm.nih.gov/pubmed/36225845
http://dx.doi.org/10.1097/GOX.0000000000004603
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