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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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The relationship between positional contracture of proximal interphalangeal joint on trigger finger and metabolic syndrome

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  • presenting/speaker Kazuya Odake - Department of Orthopaedic Surgery, Mie University, Tsu City, Mie, Japan
  • Masaya Tsujii - Department of Orthopaedic Surgery, Mie University, Tsu City, Mie, Japan
  • Akihiro Sudo - Department of Orthopaedic Surgery, Mie University, Tsu City, Mie, 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. DocIFSSH19-485

doi: 10.3205/19ifssh0907, urn:nbn:de:0183-19ifssh09071

Published: February 6, 2020

© 2020 Odake 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 (TF) is a common hand problem and sometimes leads to positional contracture of proximal interphalangeal (PIP) joint after treatments, especially it is mostly in middle finger (MF), however this has not been proven scientifically. Though several studies reported that the relationship between tendinopathy and metabolic diseases such as diabetes, obesity and dyslipidemia, there were few reports about the relationship with metabolic syndrome (MetS). we herein presented the relationship between positional contracture of PIP joint on TF and MetS

Methods: The study group was composed of 34 fingers in 34 patients (25 women and 9 men; mean age, 67.4 years), treated with corticosteroid injection or open release of the A1 pulley for TF of MF. The survey included age, sex, degrees of PIP joint before treatments(pre-PIP), height, weight, Body mass index (BMI), waist, blood examinations (T-chol, HDL, LDL, TG, FBS, HbA1c) and the prevalence of MetS. We defined -10 degrees of PIP joint after treatments (post-PIP) as positional contracture and assessed between the patients with (group P) and without contracture (group N) at 6 months after treatments.

Results and Conclusions: Thirteen fingers (38.2%) were diagnosed as positional contracture. In group P, the mean of age, waist and degrees of pre-PIP were 72.8 years, 91.0cm and -24.2°, respectively. These were significantly greater than the value (64.0 years, 81.1cm and -7.4° respectively) in group N. Additionally, there was a significant correlation between the degrees of pre-PIP and post-PIP. Besides, in group P, the mean value of HDL (60.8 mg/dL) was significantly lower than group N (74.4 mg/dL) and the those of TG (173.8 mg/dL) was significantly higher than group N (135.3 mg/dL), with significant negative correlation between TG and the degrees of post-PIP. There were no significant differences among the others. Moreover, there was a significant relevant between MetS and the presence of positional contracture.

MetS is responsible for the increase in chronic diseases, diabetes, cardiovascular disease, neurodegenerative disease, and cancer. In addition, a low-grade inflammation may have a role in the pathogenesis of MetS. Favre described that the chronic inflammation would cause an enlargement and/or shortness of tendon and induce the flexion contracture of the PIP joint. From our study, the prevalence of Mets would become the predictor of positional contracture of PIP joint on TF.