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Characteristics of patients with trigger finger associated with proximal interphalangeal joint flexion contracture and risk factors of postoperative contracture
Takafumi Hosokawa, MD, PhD
1,2, Shinsuke Arisawa, MD
2,3, Morimichi Suto, MD
2, Junko Sato, MD, PhD
4; Tsuyoshi Tajika, MD, PhD
3(1)Kiryu Orthopaedic Surgery Hospital, Kiryu, Gunma, Japan, (2)Tone Chuo Hospital, Numata, Gunma, Japan, (3)Gunma University, Maebashi, Gunma, Japan, (4)Ishii Orthopaedic & Rehabilitation Clinic, Gyoda, Saitama, Japan
Introduction
Flexion contracture of the proximal interphalangeal (PIP) joint associated with trigger finger persists in some patients even after surgery. The characteristics of patients with trigger finger associated with PIP joint contracture were investigated. We analyzed the change in range of motion with surgery and the factors that lead to PIP joint contracture at 3 months postoperatively.
Materials & Methods
Seventy-six trigger fingers (60 patients, 24 males and 36 females) operated on by the author were prospectively studied, with flexion contracture defined as PIP joint active extension ? -10°. Fingers with preoperative contracture were group C, and those without were group N. Preoperative background and postoperative results were compared. Intraoperative and postoperative active range of motion was recorded. Logistic regression analysis was performed using PIP contracture at 3 months as the objective variable to analyze risk factors.
Results
In the preoperative comparison, Group C had significantly more female patients, fewer injection histories, Quinnell classification grade 2 or higher, and a higher incidence of diabetes than Group N. Of the 71 fingers (55 patients, 22 males and 33 females) that underwent a 3-month follow-up, PIP joint contracture resolved in 63% of patients. The PIP joint extension angle was greatest during surgery. Group C had significantly smaller final PIP joint extension angles and a higher proportion of PIP joint contracture than Group N. Logistic regression analysis identified age and preoperative PIP joint contracture as significant predictors for contracture at 3 months postoperatively (odds ratios 1.16 and 9.15, respectively).
Conclusions
The risk factors for postoperative PIP joint contracture were age and preoperative contracture. This study provides information on preoperative explanations for patients and the possibility of improving postoperative PIP joint contracture.
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