DOI: 10.1177/15589447261496361 ISSN: 1558-9447

Incidence and Risk of Trigger Finger Following Carpal Tunnel Release: A Propensity-Matched Cohort Study Using a National Database

Meysam Fathi-Choghadeh, Harrison S. Fellheimer, Matthew C. Culkin, Lasya Sethi, Bryan A. Hozack, Pedro K. Beredjiklian

Background:

While an association between carpal tunnel release (CTR) and subsequent trigger finger (TF) has been reported, existing studies have widely varied and often limited sample sizes and follow-ups. This study aimed to determine the risk of new-onset TF following CTR using a large national database.

Methods:

A retrospective cohort study was conducted using the TriNetX US Collaborative Network. Patients with a diagnosis of carpal tunnel syndrome were grouped into 2 propensity score–matched cohorts: those who underwent CTR (n = 42 331) and those who did not (n = 42 331). The primary outcome was a new diagnosis of TF at various time intervals up to 5 years. Odds ratios (ORs) and Cox proportional hazards models were used to compare risk between cohorts.

Results:

During the 5-year follow-up, patients who underwent CTR had a significantly higher incidence of TF compared with the non-surgical cohort (9.2% vs 3.1%; hazard ratio, 2.56; 95% CI, 2.40-2.72; P  < .0001). The risk was most pronounced within the first 6 months postoperatively (CTR 1.9% vs non-CTR 0.4%; OR, 5.38; 95% CI, 4.53-6.39). This elevated risk remained significant at 1 year (OR, 4.41) and persisted at 5 years (OR, 3.18).

Conclusions:

This large-scale analysis demonstrates a significant and sustained association between CTR and the subsequent development of TF, with patients being over 5 times more likely to develop TF in the first 6 months after surgery. These findings underscore the importance of preoperative thorough patient counseling and postoperative awareness for early diagnosis of TF.

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