Office-Based Open Trigger Finger Release Has a Low Complication Rate

Purpose: Open trigger finger release is generally performed in the operating room in an outpatient setting. Its complication rate widely varies between 1% and 43%. Our goal was to determine whether performing this surgery in the clinic is a safe and viable alternative to performing this surgery in the operating room. Methods: All open trigger finger releases performed at our clinic between 2015 and 2019 were retrospectively reviewed. Each surgery was performed by the same fellowship-trained hand surgeon using a standard open technique with an Esmarch tourniquet and without the use of epinephrine. Five hundred twenty seven finger releases were performed in 514 patients. Complications were defined as signs or symptoms requiring further treatment. Results: There were 33 documented complications in the 527 fingers (6.3%). The most common complications were minor wound complications, including 17 (3.2%) with localized cellulitis, 2 (0.4%) with a superficial infection, 4 (0.8%) with stitch abscesses, and 5 (0.9%) with wound dehiscence. All minor complications resolved quickly with oral antibiotics and supportive care. Five patients (0.9%) required further operative management. Of these 5, 2 (0.4%) had a deep infection, 1 had chronic dehiscence, and 2 (0.4%) required flexor tenosynovectomy for persistent pain and stiffness. Conclusions: Patients who undergo open trigger finger release surgery in the clinic have complication rates similar to reported complication rates of surgery performed in the operating room. Clinical relevance: Performing open trigger finger surgery in the office is safe. We continue to perform this surgery during the coronavirus disease 2019 pandemic, when access to operating rooms and personal protective equipment is limited.