A comparison of open and percutaneous pulley release in trigger digits.

OBJECTIVE: To compare the results of open surgery with those of percutaneous surgery in patients with trigger digits.

MATERIAL AND METHOD: One hundred forty two patients with 160 trigger fingers and thumbs were prospectively randomized to either open (70 patients, 80 digits) or percutaneous (72 patients, 80 digits) surgeries at Ratchaburi Hospital. The operations were performed by one surgeon between May 1, 2007 and Dec 31, 2008. Operative time, postoperative range of motion of the finger proximal interphalangeal joint (PIP) or thumb interphalangeal joint (IP), patient satisfaction score, patient pain score, and surgical complications were assessed at weeks 1, 2, 3, 4, 6, and 8.

RESULTS: Trigger digits were successfully treated in eighty digits (100%) of the patients who underwent open surgery and in seventy-nine digits (98.75%) of the patients who underwent percutaneous surgery. Mean operative time, mean postoperative range of motion of the finger PIP or thumb IP, mean postoperative satisfaction score, and mean postoperative patient pain score were not significantly different between the groups. No serious complications were observed in either group. One patient in the percutaneous surgery group underwent open surgery two months later due to pain and locking.

CONCLUSION: Percutaneous trigger digit surgery using the full handle knife 45 degrees is effective and safe, and results functional outcomes equal to those with open trigger digit surgery.