Patient Comprehension of Trigger Finger Concepts Based on Distribution Format: A Randomized Controlled Trial of Handout Versus Video

Background: Patient comprehension is an essential part of optimizing medical outcomes. It is unknown which format is most effective in delivering this information. In addition to a face-to-face conversation, a paper handout is often given as an educational supplement at the conclusion of a visit. Secondary to advances in technology and the ubiquity of the Internet, medical videos have gained popularity. The purpose of this randomized controlled trial was to determine whether the educational material format (paper handout vs video) resulted in a difference in either comprehension of the condition or satisfaction with the delivery of the information. Methods: Patients aged ≥18 years with a diagnosis of trigger finger were prospectively enrolled and randomized to receive either a paper handout or video link with information regarding the pathophysiology, diagnosis, and treatment of trigger finger. Survey assessments were then distributed, consisting of 7 questions related to trigger finger and 1 question related to patient satisfaction. Continuous data were compared using 2-sample t tests, and categorical data were compared with χ2 tests. Alpha was 0.05. Results: Seventy-one patients were enrolled, and 60 completed their survey (response rate: 85%). The video group had significantly higher comprehension scores (82% vs 71%, P = .04) and significantly higher satisfaction scores (9.4 vs 8.6, P = .02). Conclusions: Those who received their educational material in a video format had greater comprehension of their condition and higher satisfaction compared with those receiving a paper handout. Medical providers should consider using video formats to provide supplemental educational materials to their patients.

Ultrasonography-Guided Corticosteroid Injection Combined with Versus Without Needle Knife Release of A1 Pulley for Trigger Finger

The full text of this preprint has been withdrawn by the authors due to author disagreement with the posting of the preprint. Therefore, the authors do not wish this work to be cited as a reference. Questions should be directed to the corresponding author.

Steroid Injection Using Tendon Excursion for Trigger Finger: Introduction to Injection Methods and Analysis of Treatment Results

Purpose: Local corticosteroid injections are routinely used as first-line treatment for trigger finger. However, accurate delivery of steroids into the tendon sheath is important for the effectiveness of the treatment and the prevention of complications. This study aimed to introduce our steroid injection technique for trigger finger, which uses tendon excursion of the flexor tendon, and evaluate the clinical outcomes in patients who were treated with this technique.Methods: A total of 171 patients with trigger finger who were treated with steroid injections were retrospectively reviewed. The efficacy of injection and complications were investigated. The evaluation of the efficacy was classified into “good,” “fair,” and “poor.” The results were analyzed according to the type of finger and the Quinnell grading system.Results: The total efficacy was 83.6% (good/fair, 143 digits; poor, 28 digits). The treatment success rate for Quinnell grade IV was 43.8% (7 of 16), which was significantly lower than those of Quinnell grades II and III, which were 88.9% (88 of 99) and 87.5% (49 of 56), respectively (II vs. IV, p=0.004; III vs. IV, p=0.010). In four fingers (excluding the thumb), the success rate was significantly higher than that of the thumb (88.2% vs. 75.4%, p=0.048).Conclusion: The steroid injection technique using tendon excursion showed excellent results and low complication rates. In particular, the second to fourth fingers and low-grade fingers showed more effective results.

Nanostring-Based Identification of the Gene Expression Profile in Trigger Finger Samples

Trigger finger is a common yet vastly understudied fibroproliferative hand pathology, severely affecting patients’ quality of life. Consistent trauma due to inadequate positioning within the afflicted finger’s tendon/pulley system leads to cellular dysregulation and eventual fibrosis. While the genetic characteristics of the fibrotic tissue in the trigger finger have been studied, the pathways that govern the initiation and propagation of fibrosis are still unknown. The complete gene expression profile of the trigger finger has never been explored. Our study has used the Nanostring nCounter gene expression assay to investigate the molecular signaling involved in trigger finger pathogenesis. We collected samples from patients undergoing trigger finger (n = 4) release surgery and compared the gene expression to carpal tunnel tissue (n = 4). Nanostring nCounter analysis identified 165 genes that were differentially regulated; 145 of these genes were upregulated, whereas 20 genes were downregulated. We found that several collagen genes were significantly upregulated, and a regulatory matrix metalloproteinase (MMP), MMP-3, was downregulated. Bioinformatic analysis revealed that several known signaling pathways were dysregulated, such as the TGF-β1 and Wnt signaling pathways. We also found several novel signaling pathways (e.g., PI3K, MAPK, JAK-STAT, and Notch) differentially regulated in trigger finger. The outcome of our study helps in understanding the molecular signaling pathway involved in the pathogenesis of the trigger finger.