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Early Postoperative Function After Open Versus Ultrasound-Guided Trigger Finger Release: A Prospective Comparative Cohort Study
Ophelie Z Lavoie-Gagne, MD
1,2, Karan Amin, BA
2, Rachel Cross, BA
2, Mark Cote, BS, MS
2, Ingmar Legerstee, MD
2, Dafang Zhang, MD
3; Rohit Garg, MD
2(1)Harvard Medical School, Boston, MA, (2)Massachusetts General Hospital, Boston, MA, (3)Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA
Purpose: This study aimed to compare (1) post-operative functional recovery, (2) pain, and (3) return to work between patients undergoing open versus percutaneous ultrasound-guided trigger finger release.
Methods: A prospective comparative cohort study was conducted in June 2023 through June 2024 of patients undergoing trigger finger release of the index, middle, ring, or small finger. Patients were allocated to surgical treatment based on surgeon preference. Patient-reported outcomes (PROs) evaluating functional limitations with activities of daily living (ADLs), pain, and ability to return to work were collected. Outcomes were modeled as a function of postoperative timepoint and surgical approach in generalized linear models with alpha at 0.05.
Results: A total of 54 patients (27 per group) were enrolled with no significant preoperative differences. Following ultrasound-guided release, patients demonstrated superior ADL function (-10.3 ±2.7, -8.5 ±2.9 at 3 vs 7 days, respectively) in the early post-operative period (p<0.01). After 2 weeks, there were no significant differences in ADLs or pain between cohorts. All patients continued to demonstrate ADL function improvements during follow-up (p<0.001) with a maximum improvement of -17.7 ±2.4 (p<0.001) by 6 months. Preoperative pain predicted postoperative pain (p=0.03) and statistically significant pain improvements from baseline levels occurred after 90-days (-1.1 ± 0.4; p = 0.003) regardless of surgical approach (p=0.22). Return to work by the third postoperative day was higher in the ultrasound cohort (87%) as compared to the open cohort (57%, p=0.3).
Conclusions: Minimally invasive, ultrasound-guided trigger finger release was associated with superior early postoperative ADL function compared to open release, but differences were not observed after 2 weeks. There were no differences in postoperative pain at any timepoint between groups. Ultrasound-guided trigger finger release is an option for patients seeking definitive treatment with expedited recovery.
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