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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Outcome of Stretching for Treatment of Trigger Finger in Patients on Hemodialysis

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  • presenting/speaker Nahoko Iwakura - Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
  • Yoshinori Nagata - Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
  • Rita Sasaki - Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
  • Yoshihito Takatsuki - Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
  • Yasushi Terayama - Department of Orthopaedic Surgery, Hasuda Hospital, Saitama, Japan
  • Ken Okazaki - Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-685

doi: 10.3205/19ifssh0284, urn:nbn:de:0183-19ifssh02842

Published: February 6, 2020

© 2020 Iwakura et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: Trigger finger is common in hemodialysis patients. The main treatments for trigger finger are steroid injections and surgery. This retrospective study aimed to evaluate the therapeutic effects of passive finger extension and active finger flexion exercise as conservative treatment in hemodialysis patients.

Methods: Between April 2011 and March 2017, 58 trigger fingers of 29 hemodialysis patients (10 men and 19 women) (HD group) were enrolled in this study. The mean age was 61.2 years and the mean follow-up duration was 10.9 months. All patients were instructed in the stretching method at the first visit, and the flexor tendon sheath was concurrently injected in some of the patients at their request. The modified Wolfe classification score was recorded, and compared between first and last visits. The number of injections, recurrence rate, and surgical rate were evaluated using medical records, and compared with those in non-hemodialysis patients with trigger finger (non-HD group) who were evaluated during the same period.

Results and Conclusions: There was significant improvement in the Wolfe classification score between the first and last visits. In the HD and non-HD groups, 22.4% and 43.2% did not receive injections, recurrence rates were 48.3% and 23.3%, and surgical rates were 24.1% and 4.8%, respectively. The non-injection rate was lower in the HD group. The recurrence and surgical rates were significantly higher in the HD group.

The number of hemodialysis patients has increased, and long-term dialysis patients are also increasing in japan. Trigger finger in hemodialysis patients is reportedly prone to occur in multiple fingers, and is likely to recur. Our findings showed that the recurrence and surgical rates were significantly higher in the HD group than in the non-HD group. However, stretching is an easy and noninvasive treatment, and is worth trying before surgery.