Comparison of Open and Percutaneous Treatment in Trigger Finger: Functional Results and Cost-effectiveness

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This study retrospectively compared the outcomes and costs of percutaneous needle release and traditional open release to treat trigger fingers. Methods: A retrospective analysis of patients over 18 undergoing trigger finger surgery was conducted (n=92). The patients were divided into two groups: open surgery (n=43) and percutaneous release (n=49). Treatment outcomes were assessed using the Gilbert questionnaire (failure, complications, and satisfaction), and functional outcomes were measured using the Quick Disabilities of the Arm, Shoulder, and Hand scores. The cost analysis was based on social security billing. Results: The mean Quick-Disabilities of the Arm, Shoulder, and Hand scores in the percutaneous group and 10.4±5.7 in the open surgery group (p=0.69). Finger stiffness was reported in 2 % of the percutaneous group and 30% of the open surgery group (p=0.03), whereas scarring was observed in 0% of the percutaneous group and 23% of the open surgery group (p<0.01). Returning to daily work was faster in the percutaneous group, with 67% resuming within a week compared to 0% in the open group (p<0.01). The procedure costs averaged 156.3±6.6 United States dollars for the percutaneous group and 182.9±24.2 USD (United States dollars) for the open surgery group (p<0.01). Conclusion: Percutaneous needle release appears to be a more cost-effective alternative to traditional open surgery for the trigger finger, with similar functional outcomes, faster recovery, fewer complications, and lower costs. Orthopedic Surgery Trigger Finger Open Surgical Release Percutaneous Release Cost-Effectiveness Figures Figure 1 Introduction Trigger finger is a common condition in adults, especially in women. In general, pain manifests as limited movement or obstruction of the affected finger, and tender nodules in the A1 pulley.[ 1 ] The primary pathophysiological mechanism in adults is the formation of a trigger mechanism by compression of the flexor tendon sliding in the fibrous sheath under the thickened A1 pulley, due to prolonged friction and compression.[ 2 ] In addition to this primary form, Lee et al. (2019) highlighted a secondary form of trigger finger caused by partial rupture of the flexor tendons, where the proximal edge of the lacerated tendon can impinge on the flexor tendon sheath, leading to triggering.[ 3 ] Various conservative treatments have been described for this uncomfortable condition, usually involving the thumb and second finger, such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, and immobilization using different orthoses, typically with hand therapy. [ 1 , 4 ]. Additionally, alternative treatments such as acupotomy have been investigated as potential options.[ 5 ] The success rate of conservative treatment in terms of relieving pain and eliminating triggers varies between 35% and 80%.[ 6 ] If conservative treatment failed, the A1 pulley was removed surgically. [ 7 ] Although controversial results in the literature are insufficient to determine the best treatment for trigger finger, it is generally accepted that surgical treatment should be performed in cases in which conservative treatment is inadequate. [ 8 ] However, an optimal release method for trigger fingers remains to be determined. [ 9 , 10 ] This is because each method has its advantages and disadvantages. [ 11 ] If complete release cannot be achieved using the percutaneous release method, switching to an open release is necessary. Although incomplete release and tendon damage are more common with the percutaneous method, iatrogenic digital nerve damage is a complication that can be observed using both techniques depending on the surgeon’s experience. [ 12 , 13 ]. This study aimed to compare the outcomes and costs of percutaneous needle release with those of conventional open surgical release for the treatment of trigger finger. Materials and Methods Participants and Evaluations This retrospective study was conducted in accordance with the Declaration of Helsinki and the local institutional ethics committee approved the study protocol. All patients aged > 18 years who underwent trigger finger surgery (open/percutaneous) by the senior author between May 2019 and May 2021 (N = 193) were retrospectively reviewed in the hospital records. Patients who could be reached (n = 164) via registered phone numbers were invited to the hospital for a final checkup and to participate in the study. The severity of trigger finger was graded according to the Quinnell classification. According to the Quinnell classification, grade 0 refers to normal movement, grade I refers to irregular movement, grade II refers to actively correctable movement, grade III refers to passively correctable movement, and grade IV refers to a constant deformity. [ 14 ] In our clinic, in cases of failure to benefit from conservative treatment, surgery is recommended for trigger fingers other than stage I, and the choice between open and percutaneous release is left to the patient by providing information about the advantages and disadvantages of both methods. The patients who preferred percutaneous release were treated locally on the same day. In contrast, patients who wanted open surgery were given an appointment and performed in the operating room environment. The appointment date was up to two weeks after diagnosis, and the Quinnell stage on the operation date was evaluated. Percutaneous release and open surgical procedures were performed using the methods described in recent studies. [ 15 , 16 ] Figure 1 Flow Chart In the preliminary evaluation of patients who accepted the invitation to the hospital and participated in the study (n = 139), those included in the study (n = 92, 66%) were divided into two groups: open surgical release (OS) (n = 43) and percutaneous release (PS) (n = 49). (shown in Fig. 1) An informed, voluntary consent statement was obtained from all patients to participate in the study. The independent variables included type of surgery (percutaneous vs. open), whereas the dependent variables included functional outcomes, complications, and costs. Potential confounders such as age, sex, hand dominance, and baseline severity of trigger finger (Quinnell classification) were considered. Additionally, surgeon experience and operative technique were noted as potential effect modifiers. Quick Disability of the Arm, Shoulder, and Hand (Q-DASH), valid and reliable in Turkish[ 17 ], was evaluated for patient satisfaction level, recovery time, and quantitative evaluation of patient-based results as efficacy parameters. We used a questionnaire to evaluate patient satisfaction as Gilbert and Wereldsma used in their study.[ 18 ] The questionnaire included the following questions: Do you have triggering? Do you have pain? Do you have stiffness? Do you feel numbness? Do you have a scar? Are you dissatisfied, satisfied, or very satisfied with your treatment? In addition, all patients were evaluated for reoperation and complications such as digital nerve injury, local tenderness, infection, and joint stiffness. Additionally, for cost analyses, from the moment of the patients' first application until the last control after the procedure, the amounts in our hospital's billing system and invoices from the insurance institutions were recorded as United States Dollars (USD). Potential sources of bias in this retrospective study included selection bias owing to the exclusion of unreachable patients, information bias from reliance on historical medical records, and intervention bias related to the surgeon’s experience. To address these issues, the demographic characteristics of the included and excluded patients were compared, a standardized hospital database was used for data retrieval, and all surgeries were performed by a single experienced surgeon following standardized protocols. Statistical analysis For descriptive statistics, the numerical data average, standard deviation, frequency, and ratio values ​​were used for the categorical data. Normally distributed numerical variables were examined using the Student’s t-test, ordinal variables using the Mann-Whitney U test, and categorical variables using the Chi-square test. The significance level was set as 0.05. SPSS Package Program (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM CORP) was used for statistical analysis. Results The mean ages for patients in the PS and OS groups were 49.4 ± 10.7 and 51.4 ± 11.4, respectively (p = 0.38), with no statistically significant age difference. Females comprised 88% of the PS group and 79% of the OS group (P = 0.26). No significant difference was found between groups regarding the time from symptom onset to procedure or follow-up periods (p = 0.79 and p = 0.61, respectively). Affected extremity dominance and specific finger involvement also showed no significant differences (p = 0.69, p = 0.38, respectively). Most patients fell within grade II of the Quinnell classification (49%), with both groups similarly distributed by grade (P = 0.33). (Table 1 ) Table 1 Demographics and initial findings Type of Surgery Percutaneous Surgery Open Surgery Total Gender (female/male) (n) 43/6 34/9 77/15 0.261* Age (mean ± SD) 49.4 ± 10.7 51.4 ± 11.4 50.4 ± 11.0 0.376** The time between the onset of symptoms and the procedure (n) 3 months 13 8 21 Follow-up duration (mean ± SD) (month) 36.5 ± 7.3 35.7 ± 7.6 36.1 ± 7.4 0.610** Affected extremity. (non-dominant/dominant) (n) 26/23 21/22 47/45 0.686* Affected finger. (n) 1 15 10 25 0.381* 2 4 9 13 3 14 8 22 4 14 14 28 5 2 2 4 Quinnel Grade (n) II 22 23 45 0.333*** III 18 15 33 IV 9 5 14 SD: standard deviation, *Chi-square test; **Student T test; ***Mann-Whitney U test, p < 0.005 Gilbert questionnaire data highlighted group differences in treatment outcomes, complications, and satisfaction. Finger stiffness was significantly more common in the OS group (30%) than in the PS group (2%; p = 0.03), and scar formation occurred in 23% of the OS group, but not in the PS group (p < 0.01). The trigger recurrence rates in the PS and OS groups were 6% and 5%, respectively, with no significant difference (p = 0.76). Post-procedure complications included redness and swelling, observed in one patient from each group on the third and fifth days, although antimicrobial treatment was unnecessary. Satisfaction ratings revealed that both groups had low dissatisfaction, with 4% in the PS group and 7% in the OS group citing reasons such as recurrence or pain. Overall, satisfaction was high in both groups. Notably, 67% of the patients with PS resumed daily activities within a week, whereas none of the patients with OS could do so within the same timeframe (p < 0.01). The only patient with PS who resumed activity in the third week experienced post-procedural swelling and redness. In terms of the Q-DASH scores, both groups showed no significant difference in overall functionality (p = 0.69), although the PS group resumed work activities sooner (p < 0.01). Cost analysis revealed that OS costs ( $ 182.9 ± 24.2) were significantly higher than PS costs ( $ 156.3 ± 6.6, p < 0.01). (Table 2) Table 2 Treatment efficacy parameters Type of Surgery Percutaneous Surgery Open Surgery P-value Gilbert's Questionnaire Is there triggering in your finger? (yes\no) (n) 3\46 2\41 0,76* Do you have pain? (yes\no) (n) 2\47 5\38 0.19* Do you have stiffness in your finger? (yes\no) (n) 1\48 10\33 0.03* Do you feel numbness in your finger? (yes\no) (n) 1\48 0\43 0,35* Do you have a disturbing scar on your hand? (yes\no) (n) 0\49 10\33 0.01* Are you satisfied with the procedure? (Not Satisfied\ Satisfied\ Very Satisfied) (n) 2\20\27 3\21\19 0.27** Return to daily routine work after the procedure. Do not remember 0 1 < 0.01*** In the first week 33 0 In the second week 15 24 3rd week and later 1 18 Q-DASH Total score (mean ± SD) 10 ± 5.7 10.4 ± 5.7 0.69** Cost of the procedure [USD ($)] (mean ± SD) 156.3 ± 6.6 182.9 ± 24.2 < 0.01*** SD: standard deviation, *Chi-square test; ** Mann-Whitney U test, ***Student T-test, ***Fisher's Exact Test, p < 0.005 Discussion In this study, in which the results and procedural costs of open surgery and percutaneous surgery were compared for the surgical treatment of trigger finger, PS demonstrated some advantages over OS in terms of the presence of stiffness in the finger, disturbing scarring in the hand, time to return to daily work after the procedure, and treatment costs. Lin et al. compared the results of open and percutaneous surgeries in 198 patients with trigger finger. No signs of finger stiffness were observed in either of the groups. However, in the short-term (three months) results, scarring and patient dissatisfaction were significantly higher in the OS group. However, in the long-term (2 years) evaluation, no significant differences were observed between the groups for any of the parameters.[ 16 ] In our study, the sensation of stiffness in the fingers and uncomfortable scars on the hand were significantly higher in the open surgery group. In a study by Wang et al., in adults with trigger fingers, treatment failure and the frequency of complications were similar between percutaneous release and open surgery. Patients treated with percutaneous surgery are less likely to experience treatment failure than those treated with corticosteroid injection. [ 12 ] In our study, triggering and pain were evaluated as posttreatment failures. Although triggering appeared to be more significant in the PS group, this difference was not statistically significant, consistent with the results of Lin et al. [ 16 ] In the evaluation of complications, significantly more patients in the OS group complained of stiffness sensations in their fingers. When patients with stiffness findings were questioned in detail, they stated that they started finger movements late because of fear of suture failure at the wound site or pain due to the sutures. Only one patient in the PS group reported a sensation of stiffness; however, this patient returned to daily activities within the first week without any delay in starting movements. At the same time, the rate of joint stiffness sensation in the PS group was 1% in the study by Çimen et al.[ 13 ], which was 2% in our study. However, in studies by Güler et al.[ 19 ] and Cebesoy et al.[ 15 ], this rate was 0%. Similar to the present study, all three studies mentioned that the patients did not undergo a rehabilitation program or orthosis. A rare complication of open surgery is the formation of multiple ganglion cysts along the flexor tendon sheath, as reported by Lee et al.[ 20 ] Still, this complication was not observed in our patients​. In a meta-analysis by Wang et al., the postoperative satisfaction rate was evaluated in two studies and calculated as 92% in the PS group. The rates in this study were 95% and 90% in the PS and OS groups, respectively. The Q-DASH results showed that the two methods were similar in terms of functionality and patient satisfaction. [ 12 ] Some studies have emphasized the disadvantages of open surgery. For example, Fiorini et al. emphasized that open trigger finger surgery increased the incidence of pain during the first week of follow-up. However, the recurrence rate was low over the next six–12 months of follow-up. This study did not report the results for hand function or participant satisfaction. [ 9 ] Other studies have reported that open surgery is associated with longer recovery times and more complications such as tendon bending, digital ulnar slippage, and nerve injuries. [ 10 ] In our study, the fact that the return to daily activities was significantly delayed after the procedure in the OS group was interpreted as a longer recovery time in the patients who underwent this procedure. Although the difference was not statistically significant, the number of pain complaints was higher in the OS group. In the study by Xie et al., no significant difference was found between the percutaneous and OS groups in terms of the visual analog scale, Quinnell grade; disabilities of arm, shoulder, and hand scores, and finger total range of motion score. Percutaneous surgery has been suggested as an effective and safe method for the treatment of trigger fingers. [ 8 ] Gil et al. stated that open surgery effectively alleviates the subjective and objective symptoms of the disease and continues to be the reference intervention, suggesting that percutaneous release should be performed by a surgeon who has received additional training to become proficient in this technique.[ 21 ] The senior author has applied the percutaneous release technique for eight years, and our clinic is experienced in this regard. Modified acupotomy has been proposed as an alternative to percutaneous release and open surgery for the trigger fingers. While it is suggested to reduce recurrence and complications with higher long-term satisfaction, evidence remains limited. [ 22 ] The unique design aims to minimize tendon and nerve injury, but since this technique is not used in our clinic, we have no practical experience regarding its efficacy or safety. Stirling et al. evaluated the cost-effectiveness of open surgery and A1 pulley release and showed that open surgery is cost-effective if the benefit is maintained for two years. [ 23 ] Gancarczyk et al. compared the costs of open surgery in hospitals, outpatient centers, and percutaneous releases in offices. Their findings showed that in-office percutaneous release was the most cost-effective, followed by open surgery, in outpatient centers, whereas hospital-based open surgery was the least cost-effective, with nearly double percutaneous release. [ 24 ] In our study, open surgery was approximately 16% more expensive than percutaneous surgery, factoring in dressing and suture removal and underscoring implications for health fund sustainability. With no consensus on the optimal trigger finger treatment, some studies have suggested involving patients in treatment choices to improve satisfaction. Blough et al. preferred less invasive therapies, although the respondents were hypothetical and may lack first-hand trigger finger experience. [ 25 ] At our clinic, patients are informed about open and percutaneous release, and they make decisions accordingly. Limitations As a retrospective analysis, this study relied on historical medical records, which may have included inaccurate or incomplete data. Additionally, heterogeneity in the study population, including differences in age, trigger finger severity, and hand dominance, may have affected the interpretability of the results. This retrospective study design prevented preoperative Gilberts and Q-DASH assessments, limiting the ability to fully compare the baseline functional outcomes. Patients with PS often express satisfaction owing to immediate treatment post-diagnosis, which is potentially influenced by scheduling constraints in our clinic. Additionally, variations in surgeon experience, which were not controlled for, may have influenced the outcomes, and should be considered in future studies. Furthermore, the long-term outcomes were not evaluated, which prevented a comprehensive assessment of the durability and safety of the two surgical methods. This study was conducted at a single tertiary care center, which limits its generalizability to other healthcare settings. Our findings may be more applicable to similar tertiary care settings, and validation in multicenter or community-based studies is necessary. Conclusions This study demonstrated that both open and percutaneous surgical techniques are effective in treating trigger fingers unresponsive to conservative treatment. Although both methods yield similar functional outcomes, as evidenced by the Q-DASH scores, percutaneous needle release offers distinct advantages, including significantly reduced sensation of finger stiffness, absence of scarring, faster recovery times, and lower costs. These benefits make it a compelling option for patients seeking minimally invasive treatment. However, open surgery remains a reliable alternative, particularly in cases that require direct visualization, or in patients unsuitable for percutaneous techniques. Further large-scale prospective studies are needed to refine these findings and to explore the long-term implications of each approach. By incorporating patient preferences, specific clinical scenarios, and cost-effectiveness analyses into the decision-making process, healthcare providers can optimize outcomes and enhance patient satisfaction in diverse populations. Declarations Conflict of Interest On behalf of all authors, the corresponding author states that there is no conflict of interest. Ethical Statements This study did not involve any experiments on animals. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was conducted in accordance with the ethical standards outlined in the Declaration of Helsinki and was approved by the Clinical Investigations Ethical Committee of xxxxxxxxxxxx (Approval No: xxxxxxxxxxxx, Date: xxxxxxxxxxxx). Informed Consent All participants provided written informed consent prior to their inclusion in the study. For participants who were unable to provide consent directly, consent was obtained from their legal guardians or next of kin. 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J Hand Surgery: Eur Volume 45(10):1083–1086. https://doi.org/10.1177/1753193420926420 Gancarczyk SM, Jang ES, Swart EP, Makhni EC, Kadiyala RK (2016) Percutaneous trigger finger release: A cost-effectiveness analysis. J Am Acad Orthop Surg 24(7):475–482. https://doi.org/10.5435/JAAOS-D-16-00042 Blough C, Najdawi J, Kuschner S (2022) Patient preference for trigger finger treatment. World J Orthop 13(11):1006–1014. https://doi.org/10.5312/wjo.v13.i11.1006 Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Published Journal Publication published 25 Aug, 2025 Read the published version in Indian Journal of Orthopaedics → Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5875548","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Method Article","associatedPublications":[],"authors":[{"id":405253123,"identity":"c19c9c7c-6523-406b-aff7-2e660c9ffa1c","order_by":0,"name":"OĞUZHAN GÖKALP","email":"data:image/png;base64,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","orcid":"https://orcid.org/0000-0003-4062-8559","institution":"Uşak University Medical Faculty","correspondingAuthor":true,"prefix":"","firstName":"OĞUZHAN","middleName":"","lastName":"GÖKALP","suffix":""},{"id":405253124,"identity":"5d598c39-c34a-45cd-a60b-b610c0bd06c0","order_by":1,"name":"GÖKHAN İLYAS","email":"","orcid":"https://orcid.org/0000-0002-5750-1346","institution":"Uşak University Medical Faculty","correspondingAuthor":false,"prefix":"","firstName":"GÖKHAN","middleName":"","lastName":"İLYAS","suffix":""},{"id":405253125,"identity":"29911e24-0dbc-445c-b197-b4069f188c07","order_by":2,"name":"FİKRİ BURAK İPÇİ","email":"","orcid":"https://orcid.org/0000-0002-8367-3459","institution":"Uşak University Medical Faculty","correspondingAuthor":false,"prefix":"","firstName":"FİKRİ","middleName":"BURAK","lastName":"İPÇİ","suffix":""}],"badges":[],"createdAt":"2025-01-21 19:04:28","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-5875548/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5875548/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s43465-025-01532-0","type":"published","date":"2025-08-26T00:00:00+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":74679953,"identity":"92c6bb22-188e-4406-9e54-a2155f7a057b","added_by":"auto","created_at":"2025-01-24 15:41:40","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":362754,"visible":true,"origin":"","legend":"\u003cp\u003eSee image above for figure legend\u003c/p\u003e","description":"","filename":"figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5875548/v1/cf8cd338894108de0f7870ef.jpg"},{"id":95137333,"identity":"9dc2cfcc-f0cf-4339-8150-e2af653f6270","added_by":"auto","created_at":"2025-11-04 16:25:42","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1143013,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5875548/v1/99e6bf22-d25a-41da-be74-641ae5a9145e.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003eComparison of Open and Percutaneous Treatment in Trigger Finger: Functional Results and Cost-effectiveness\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eTrigger finger is a common condition in adults, especially in women. In general, pain manifests as limited movement or obstruction of the affected finger, and tender nodules in the A1 pulley.[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] The primary pathophysiological mechanism in adults is the formation of a trigger mechanism by compression of the flexor tendon sliding in the fibrous sheath under the thickened A1 pulley, due to prolonged friction and compression.[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] In addition to this primary form, Lee et al. (2019) highlighted a secondary form of trigger finger caused by partial rupture of the flexor tendons, where the proximal edge of the lacerated tendon can impinge on the flexor tendon sheath, leading to triggering.[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] Various conservative treatments have been described for this uncomfortable condition, usually involving the thumb and second finger, such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, and immobilization using different orthoses, typically with hand therapy. [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Additionally, alternative treatments such as acupotomy have been investigated as potential options.[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e] The success rate of conservative treatment in terms of relieving pain and eliminating triggers varies between 35% and 80%.[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] If conservative treatment failed, the A1 pulley was removed surgically. [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eAlthough controversial results in the literature are insufficient to determine the best treatment for trigger finger, it is generally accepted that surgical treatment should be performed in cases in which conservative treatment is inadequate. [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] However, an optimal release method for trigger fingers remains to be determined. [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] This is because each method has its advantages and disadvantages. [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] If complete release cannot be achieved using the percutaneous release method, switching to an open release is necessary. Although incomplete release and tendon damage are more common with the percutaneous method, iatrogenic digital nerve damage is a complication that can be observed using both techniques depending on the surgeon\u0026rsquo;s experience. [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThis study aimed to compare the outcomes and costs of percutaneous needle release with those of conventional open surgical release for the treatment of trigger finger.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eParticipants and Evaluations\u003c/h2\u003e \u003cp\u003e This retrospective study was conducted in accordance with the Declaration of Helsinki and the local institutional ethics committee approved the study protocol. All patients aged\u0026thinsp;\u0026gt;\u0026thinsp;18 years who underwent trigger finger surgery (open/percutaneous) by the senior author between May 2019 and May 2021 (N\u0026thinsp;=\u0026thinsp;193) were retrospectively reviewed in the hospital records. Patients who could be reached (n\u0026thinsp;=\u0026thinsp;164) via registered phone numbers were invited to the hospital for a final checkup and to participate in the study.\u003c/p\u003e \u003cp\u003eThe severity of trigger finger was graded according to the Quinnell classification. According to the Quinnell classification, grade 0 refers to normal movement, grade I refers to irregular movement, grade II refers to actively correctable movement, grade III refers to passively correctable movement, and grade IV refers to a constant deformity. [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] In our clinic, in cases of failure to benefit from conservative treatment, surgery is recommended for trigger fingers other than stage I, and the choice between open and percutaneous release is left to the patient by providing information about the advantages and disadvantages of both methods. The patients who preferred percutaneous release were treated locally on the same day. In contrast, patients who wanted open surgery were given an appointment and performed in the operating room environment. The appointment date was up to two weeks after diagnosis, and the Quinnell stage on the operation date was evaluated. Percutaneous release and open surgical procedures were performed using the methods described in recent studies. [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/p\u003e \u003cp\u003e \u003cb\u003eFigure\u0026nbsp;1 Flow Chart\u003c/b\u003e \u003c/p\u003e \u003cp\u003eIn the preliminary evaluation of patients who accepted the invitation to the hospital and participated in the study (n\u0026thinsp;=\u0026thinsp;139), those included in the study (n\u0026thinsp;=\u0026thinsp;92, 66%) were divided into two groups: open surgical release (OS) (n\u0026thinsp;=\u0026thinsp;43) and percutaneous release (PS) (n\u0026thinsp;=\u0026thinsp;49). (shown in Fig.\u0026nbsp; 1) An informed, voluntary consent statement was obtained from all patients to participate in the study.\u003c/p\u003e \u003cp\u003eThe independent variables included type of surgery (percutaneous vs. open), whereas the dependent variables included functional outcomes, complications, and costs. Potential confounders such as age, sex, hand dominance, and baseline severity of trigger finger (Quinnell classification) were considered. Additionally, surgeon experience and operative technique were noted as potential effect modifiers. Quick Disability of the Arm, Shoulder, and Hand (Q-DASH), valid and reliable in Turkish[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], was evaluated for patient satisfaction level, recovery time, and quantitative evaluation of patient-based results as efficacy parameters.\u003c/p\u003e \u003cp\u003eWe used a questionnaire to evaluate patient satisfaction as Gilbert and Wereldsma used in their study.[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] The questionnaire included the following questions: Do you have triggering? Do you have pain? Do you have stiffness? Do you feel numbness? Do you have a scar? Are you dissatisfied, satisfied, or very satisfied with your treatment? In addition, all patients were evaluated for reoperation and complications such as digital nerve injury, local tenderness, infection, and joint stiffness. Additionally, for cost analyses, from the moment of the patients' first application until the last control after the procedure, the amounts in our hospital's billing system and invoices from the insurance institutions were recorded as United States Dollars (USD).\u003c/p\u003e \u003cp\u003ePotential sources of bias in this retrospective study included selection bias owing to the exclusion of unreachable patients, information bias from reliance on historical medical records, and intervention bias related to the surgeon\u0026rsquo;s experience. To address these issues, the demographic characteristics of the included and excluded patients were compared, a standardized hospital database was used for data retrieval, and all surgeries were performed by a single experienced surgeon following standardized protocols.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eFor descriptive statistics, the numerical data average, standard deviation, frequency, and ratio values ​​were used for the categorical data. Normally distributed numerical variables were examined using the Student\u0026rsquo;s t-test, ordinal variables using the Mann-Whitney U test, and categorical variables using the Chi-square test. The significance level was set as 0.05. SPSS Package Program (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM CORP) was used for statistical analysis.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThe mean ages for patients in the PS and OS groups were 49.4\u0026thinsp;\u0026plusmn;\u0026thinsp;10.7 and 51.4\u0026thinsp;\u0026plusmn;\u0026thinsp;11.4, respectively (p\u0026thinsp;=\u0026thinsp;0.38), with no statistically significant age difference. Females comprised 88% of the PS group and 79% of the OS group (P\u0026thinsp;=\u0026thinsp;0.26). No significant difference was found between groups regarding the time from symptom onset to procedure or follow-up periods (p\u0026thinsp;=\u0026thinsp;0.79 and p\u0026thinsp;=\u0026thinsp;0.61, respectively). Affected extremity dominance and specific finger involvement also showed no significant differences (p\u0026thinsp;=\u0026thinsp;0.69, p\u0026thinsp;=\u0026thinsp;0.38, respectively). Most patients fell within grade II of the Quinnell classification (49%), with both groups similarly distributed by grade (P\u0026thinsp;=\u0026thinsp;0.33). (Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eDemographics and initial findings\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colspan=\"2\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eType of Surgery\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercutaneous\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eSurgery\u003c/strong\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eOpen\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eSurgery\u003c/strong\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003cp\u003e(female/male) (n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e43/6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34/9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e77/15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.261*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003cp\u003e(mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e49.4\u0026thinsp;\u0026plusmn;\u0026thinsp;10.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51.4\u0026thinsp;\u0026plusmn;\u0026thinsp;11.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50.4\u0026thinsp;\u0026plusmn;\u0026thinsp;11.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.376**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eThe time between the onset of symptoms and the procedure (n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;\u0026thinsp;1 month\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003e0.785***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u0026ndash;3 month\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026gt;\u0026thinsp;3 months\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eFollow-up duration (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD) (month)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36.5\u0026thinsp;\u0026plusmn;\u0026thinsp;7.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35.7\u0026thinsp;\u0026plusmn;\u0026thinsp;7.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36.1\u0026thinsp;\u0026plusmn;\u0026thinsp;7.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.610**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eAffected extremity.\u003c/p\u003e\n \u003cp\u003e(non-dominant/dominant) (n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26/23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21/22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47/45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.686*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003eAffected finger.\u003c/p\u003e\n \u003cp\u003e(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003e0.381*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e4\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eQuinnel Grade\u003c/p\u003e\n \u003cp\u003e(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eII\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003e0.333***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eIII\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eIV\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"6\"\u003e\n \u003cp\u003e\u003cstrong\u003eSD: standard deviation, *Chi-square test; **Student T test; ***Mann-Whitney U test, p\u0026thinsp;\u0026lt;\u0026thinsp;0.005\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eGilbert questionnaire data highlighted group differences in treatment outcomes, complications, and satisfaction. Finger stiffness was significantly more common in the OS group (30%) than in the PS group (2%; p\u0026thinsp;=\u0026thinsp;0.03), and scar formation occurred in 23% of the OS group, but not in the PS group (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01). The trigger recurrence rates in the PS and OS groups were 6% and 5%, respectively, with no significant difference (p\u0026thinsp;=\u0026thinsp;0.76).\u003c/p\u003e\n\u003cp\u003ePost-procedure complications included redness and swelling, observed in one patient from each group on the third and fifth days, although antimicrobial treatment was unnecessary. Satisfaction ratings revealed that both groups had low dissatisfaction, with 4% in the PS group and 7% in the OS group citing reasons such as recurrence or pain. Overall, satisfaction was high in both groups.\u003c/p\u003e\n\u003cp\u003eNotably, 67% of the patients with PS resumed daily activities within a week, whereas none of the patients with OS could do so within the same timeframe (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01). The only patient with PS who resumed activity in the third week experienced post-procedural swelling and redness.\u003c/p\u003e\n\u003cp\u003eIn terms of the Q-DASH scores, both groups showed no significant difference in overall functionality (p\u0026thinsp;=\u0026thinsp;0.69), although the PS group resumed work activities sooner (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01). Cost analysis revealed that OS costs (\u003cspan\u003e$\u003c/span\u003e182.9\u0026thinsp;\u0026plusmn;\u0026thinsp;24.2) were significantly higher than PS costs (\u003cspan\u003e$\u003c/span\u003e156.3\u0026thinsp;\u0026plusmn;\u0026thinsp;6.6, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01). (Table\u0026nbsp;2)\u003c/p\u003e\n\u003cp\u003eTable 2 Treatment efficacy parameters\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Taba\" border=\"1\" style=\"margin-right: calc(0%); width: 100%;\"\u003e\n \u003ccolgroup cols=\"6\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colspan=\"2\" rowspan=\"2\" style=\"width: 42.8807%;\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\" colspan=\"3\" style=\"width: 24.464%;\"\u003e\n \u003cp\u003eType of Surgery\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" style=\"width: 11.5448%;\"\u003e\n \u003cp\u003ePercutaneous Surgery\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" style=\"width: 7.33%;\"\u003e\n \u003cp\u003eOpen Surgery\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" style=\"width: 5.5892%;\"\u003e\n \u003cp\u003eP-value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"6\" style=\"width: 20.6157%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGilbert\u0026apos;s Questionnaire\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 22.265%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIs there triggering in your finger?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(yes\\no) (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 11.5448%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3\\46\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 7.33%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2\\41\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 5.5892%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,76*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 22.265%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you have pain?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(yes\\no) (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 11.5448%;\"\u003e\n \u003cp\u003e2\\47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 7.33%;\"\u003e\n \u003cp\u003e5\\38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 5.5892%;\"\u003e\n \u003cp\u003e0.19*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 22.265%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you have stiffness in your finger?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(yes\\no) (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 11.5448%;\"\u003e\n \u003cp\u003e1\\48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 7.33%;\"\u003e\n \u003cp\u003e10\\33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 5.5892%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.03*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 22.265%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you feel numbness in your finger?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(yes\\no) (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 11.5448%;\"\u003e\n \u003cp\u003e1\\48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 7.33%;\"\u003e\n \u003cp\u003e0\\43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 5.5892%;\"\u003e\n \u003cp\u003e0,35*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 22.265%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you have a disturbing scar on your hand? (yes\\no) (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 11.5448%;\"\u003e\n \u003cp\u003e0\\49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 7.33%;\"\u003e\n \u003cp\u003e10\\33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 5.5892%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.01*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 22.265%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAre you satisfied with the procedure?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(Not Satisfied\\ Satisfied\\ Very Satisfied) (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 11.5448%;\"\u003e\n \u003cp\u003e2\\20\\27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 7.33%;\"\u003e\n \u003cp\u003e3\\21\\19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 5.5892%;\"\u003e\n \u003cp\u003e0.27**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\" style=\"width: 20.6157%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReturn to daily routine work after the procedure.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 22.265%;\"\u003e\n \u003cp\u003eDo not remember\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 11.5448%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 7.33%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"4\" style=\"width: 5.5892%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;\u0026thinsp;0.01***\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 22.265%;\"\u003e\n \u003cp\u003eIn the first week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 11.5448%;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 7.33%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 22.265%;\"\u003e\n \u003cp\u003eIn the second week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 11.5448%;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 7.33%;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 22.265%;\"\u003e\n \u003cp\u003e3rd week and later\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 11.5448%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 7.33%;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 42.8807%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eQ-DASH Total score (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 11.5448%;\"\u003e\n \u003cp\u003e10\u0026thinsp;\u0026plusmn;\u0026thinsp;5.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 7.33%;\"\u003e\n \u003cp\u003e10.4\u0026thinsp;\u0026plusmn;\u0026thinsp;5.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 5.5892%;\"\u003e\n \u003cp\u003e0.69**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 42.8807%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCost of the procedure [USD ($)] (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 11.5448%;\"\u003e\n \u003cp\u003e156.3\u0026thinsp;\u0026plusmn;\u0026thinsp;6.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 7.33%;\"\u003e\n \u003cp\u003e182.9\u0026thinsp;\u0026plusmn;\u0026thinsp;24.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 5.5892%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;\u0026thinsp;0.01***\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"5\" style=\"width: 67.3447%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSD: standard deviation, *Chi-square test; ** Mann-Whitney U test, ***Student T-test, ***Fisher\u0026apos;s Exact Test, p\u0026thinsp;\u0026lt;\u0026thinsp;0.005\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study, in which the results and procedural costs of open surgery and percutaneous surgery were compared for the surgical treatment of trigger finger, PS demonstrated some advantages over OS in terms of the presence of stiffness in the finger, disturbing scarring in the hand, time to return to daily work after the procedure, and treatment costs.\u003c/p\u003e \u003cp\u003eLin et al. compared the results of open and percutaneous surgeries in 198 patients with trigger finger. No signs of finger stiffness were observed in either of the groups. However, in the short-term (three months) results, scarring and patient dissatisfaction were significantly higher in the OS group. However, in the long-term (2 years) evaluation, no significant differences were observed between the groups for any of the parameters.[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] In our study, the sensation of stiffness in the fingers and uncomfortable scars on the hand were significantly higher in the open surgery group.\u003c/p\u003e \u003cp\u003eIn a study by Wang et al., in adults with trigger fingers, treatment failure and the frequency of complications were similar between percutaneous release and open surgery. Patients treated with percutaneous surgery are less likely to experience treatment failure than those treated with corticosteroid injection. [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] In our study, triggering and pain were evaluated as posttreatment failures. Although triggering appeared to be more significant in the PS group, this difference was not statistically significant, consistent with the results of Lin et al. [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eIn the evaluation of complications, significantly more patients in the OS group complained of stiffness sensations in their fingers. When patients with stiffness findings were questioned in detail, they stated that they started finger movements late because of fear of suture failure at the wound site or pain due to the sutures. Only one patient in the PS group reported a sensation of stiffness; however, this patient returned to daily activities within the first week without any delay in starting movements. At the same time, the rate of joint stiffness sensation in the PS group was 1% in the study by \u0026Ccedil;imen et al.[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], which was 2% in our study. However, in studies by G\u0026uuml;ler et al.[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] and Cebesoy et al.[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e], this rate was 0%. Similar to the present study, all three studies mentioned that the patients did not undergo a rehabilitation program or orthosis. A rare complication of open surgery is the formation of multiple ganglion cysts along the flexor tendon sheath, as reported by Lee et al.[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] Still, this complication was not observed in our patients​.\u003c/p\u003e \u003cp\u003eIn a meta-analysis by Wang et al., the postoperative satisfaction rate was evaluated in two studies and calculated as 92% in the PS group. The rates in this study were 95% and 90% in the PS and OS groups, respectively. The Q-DASH results showed that the two methods were similar in terms of functionality and patient satisfaction. [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eSome studies have emphasized the disadvantages of open surgery. For example, Fiorini et al. emphasized that open trigger finger surgery increased the incidence of pain during the first week of follow-up. However, the recurrence rate was low over the next six\u0026ndash;12 months of follow-up. This study did not report the results for hand function or participant satisfaction. [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] Other studies have reported that open surgery is associated with longer recovery times and more complications such as tendon bending, digital ulnar slippage, and nerve injuries. [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] In our study, the fact that the return to daily activities was significantly delayed after the procedure in the OS group was interpreted as a longer recovery time in the patients who underwent this procedure. Although the difference was not statistically significant, the number of pain complaints was higher in the OS group.\u003c/p\u003e \u003cp\u003eIn the study by Xie et al., no significant difference was found between the percutaneous and OS groups in terms of the visual analog scale, Quinnell grade; disabilities of arm, shoulder, and hand scores, and finger total range of motion score. Percutaneous surgery has been suggested as an effective and safe method for the treatment of trigger fingers. [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] Gil et al. stated that open surgery effectively alleviates the subjective and objective symptoms of the disease and continues to be the reference intervention, suggesting that percutaneous release should be performed by a surgeon who has received additional training to become proficient in this technique.[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] The senior author has applied the percutaneous release technique for eight years, and our clinic is experienced in this regard.\u003c/p\u003e \u003cp\u003eModified acupotomy has been proposed as an alternative to percutaneous release and open surgery for the trigger fingers. While it is suggested to reduce recurrence and complications with higher long-term satisfaction, evidence remains limited. [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] The unique design aims to minimize tendon and nerve injury, but since this technique is not used in our clinic, we have no practical experience regarding its efficacy or safety.\u003c/p\u003e \u003cp\u003eStirling et al. evaluated the cost-effectiveness of open surgery and A1 pulley release and showed that open surgery is cost-effective if the benefit is maintained for two years. [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e] Gancarczyk et al. compared the costs of open surgery in hospitals, outpatient centers, and percutaneous releases in offices. Their findings showed that in-office percutaneous release was the most cost-effective, followed by open surgery, in outpatient centers, whereas hospital-based open surgery was the least cost-effective, with nearly double percutaneous release. [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] In our study, open surgery was approximately 16% more expensive than percutaneous surgery, factoring in dressing and suture removal and underscoring implications for health fund sustainability.\u003c/p\u003e \u003cp\u003eWith no consensus on the optimal trigger finger treatment, some studies have suggested involving patients in treatment choices to improve satisfaction. Blough et al. preferred less invasive therapies, although the respondents were hypothetical and may lack first-hand trigger finger experience. [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e] At our clinic, patients are informed about open and percutaneous release, and they make decisions accordingly.\u003c/p\u003e"},{"header":"Limitations","content":"\u003cp\u003eAs a retrospective analysis, this study relied on historical medical records, which may have included inaccurate or incomplete data. Additionally, heterogeneity in the study population, including differences in age, trigger finger severity, and hand dominance, may have affected the interpretability of the results. This retrospective study design prevented preoperative Gilberts and Q-DASH assessments, limiting the ability to fully compare the baseline functional outcomes. Patients with PS often express satisfaction owing to immediate treatment post-diagnosis, which is potentially influenced by scheduling constraints in our clinic. Additionally, variations in surgeon experience, which were not controlled for, may have influenced the outcomes, and should be considered in future studies. Furthermore, the long-term outcomes were not evaluated, which prevented a comprehensive assessment of the durability and safety of the two surgical methods.\u003c/p\u003e \u003cp\u003eThis study was conducted at a single tertiary care center, which limits its generalizability to other healthcare settings. Our findings may be more applicable to similar tertiary care settings, and validation in multicenter or community-based studies is necessary.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis study demonstrated that both open and percutaneous surgical techniques are effective in treating trigger fingers unresponsive to conservative treatment. Although both methods yield similar functional outcomes, as evidenced by the Q-DASH scores, percutaneous needle release offers distinct advantages, including significantly reduced sensation of finger stiffness, absence of scarring, faster recovery times, and lower costs. These benefits make it a compelling option for patients seeking minimally invasive treatment. However, open surgery remains a reliable alternative, particularly in cases that require direct visualization, or in patients unsuitable for percutaneous techniques.\u003c/p\u003e \u003cp\u003eFurther large-scale prospective studies are needed to refine these findings and to explore the long-term implications of each approach. By incorporating patient preferences, specific clinical scenarios, and cost-effectiveness analyses into the decision-making process, healthcare providers can optimize outcomes and enhance patient satisfaction in diverse populations.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch3\u003eConflict of Interest\u003c/h3\u003e\n\u003cp\u003eOn behalf of all authors, the corresponding author states that there is no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Statements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study did not involve any experiments on animals. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance with the ethical standards outlined in the Declaration of Helsinki and was approved by the Clinical Investigations Ethical Committee of xxxxxxxxxxxx (Approval No: xxxxxxxxxxxx, Date: xxxxxxxxxxxx).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed Consent\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll participants provided written informed consent prior to their inclusion in the study. For participants who were unable to provide consent directly, consent was obtained from their legal guardians or next of kin.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eLunsford D, Valdes K, Hengy S (2019) Conservative management of trigger finger: A systematic review. J Hand Ther 32(2):212\u0026ndash;221. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.jht.2017.10.016\u003c/span\u003e\u003cspan address=\"10.1016/j.jht.2017.10.016\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMerry SP, O\u0026rsquo;Grady JS, Boswell CL (2020) Trigger Finger? Just Shoot! 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World J Orthop 13(11):1006\u0026ndash;1014. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.5312/wjo.v13.i11.1006\u003c/span\u003e\u003cspan address=\"10.5312/wjo.v13.i11.1006\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"Usak University","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Trigger Finger, Open Surgical Release, Percutaneous Release, Cost-Effectiveness","lastPublishedDoi":"10.21203/rs.3.rs-5875548/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5875548/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cem\u003eIntroduction:\u003c/em\u003e Trigger finger, a common condition caused by flexor tendon compression in adults, often requires surgical release when conservative treatment fails. This study retrospectively compared the outcomes and costs of percutaneous needle release and traditional open release to treat trigger fingers.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMethods:\u003c/em\u003e A retrospective analysis of patients over 18 undergoing trigger finger surgery was conducted (n=92). The patients were divided into two groups: open surgery (n=43) and percutaneous release (n=49). Treatment outcomes were assessed using the Gilbert questionnaire (failure, complications, and satisfaction), and functional outcomes were measured using the Quick Disabilities of the Arm, Shoulder, and Hand scores. The cost analysis was based on social security billing.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eResults:\u003c/em\u003e The mean Quick-Disabilities of the Arm, Shoulder, and Hand scores in the percutaneous group and 10.4±5.7 in the open surgery group (p=0.69). Finger stiffness was reported in 2 % of the percutaneous group and 30% of the open surgery group (p=0.03), whereas scarring was observed in 0% of the percutaneous group and 23% of the open surgery group (p\u0026lt;0.01). Returning to daily work was faster in the percutaneous group, with 67% resuming within a week compared to 0% in the open group (p\u0026lt;0.01). The procedure costs averaged 156.3±6.6 United States dollars for the percutaneous group and 182.9±24.2 USD (United States dollars) for the open surgery group (p\u0026lt;0.01).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eConclusion:\u003c/em\u003e Percutaneous needle release appears to be a more cost-effective alternative to traditional open surgery for the trigger finger, with similar functional outcomes, faster recovery, fewer complications, and lower costs.\u003c/p\u003e","manuscriptTitle":"Comparison of Open and Percutaneous Treatment in Trigger Finger: Functional Results and Cost-effectiveness","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-01-24 15:41:36","doi":"10.21203/rs.3.rs-5875548/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"30776c2f-a783-4776-9cf9-21ca9563bc72","owner":[],"postedDate":"January 24th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":43345321,"name":"Orthopedic Surgery"}],"tags":[],"updatedAt":"2025-11-04T16:25:37+00:00","versionOfRecord":{"articleIdentity":"rs-5875548","link":"https://doi.org/10.1007/s43465-025-01532-0","journal":{"identity":"indian-journal-of-orthopaedics","isVorOnly":false,"title":"Indian Journal of Orthopaedics"},"publishedOn":"2025-08-26 00:00:00","publishedOnDateReadable":"August 26th, 2025"},"versionCreatedAt":"2025-01-24 15:41:36","video":"","vorDoi":"10.1007/s43465-025-01532-0","vorDoiUrl":"https://doi.org/10.1007/s43465-025-01532-0","workflowStages":[]},"version":"v1","identity":"rs-5875548","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5875548","identity":"rs-5875548","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}