O24: Triggering Change: Evaluating Minimally Invasive Techniques in the Pandemic-Era Hand Surgery in Malaysia

Aims This study aimed to compare outcomes of open surgical release versus ultrasound-guided and anatomical landmark-guided percutaneous release techniques for trigger finger treatment during the COVID-19 pandemic (year 2020-2022) at a single centre in Malaysia. Methods A retrospective review was conducted for 44 patients (94 digits) who underwent open surgical release (OS, n=52 digits), ultrasound-guided percutaneous release (UPR, n=30 digits), or anatomical landmark-guided percutaneous release (APR, n=12 digits) for trigger finger from 2020-2022. Outcomes assessed included post-operative pain, triggering recurrence, time to return to work/activities, patient satisfaction, and complications. Results Patients undergoing percutaneous release had expedited return to work/activities (3 days) compared to open surgery (20 days) (p<0.0001). No UPR/APR patients reported persistent pain at 3 months versus 13.5% of OS patients. Recurrence rates were comparable between modalities (1.9% vs 2.4%). Patient satisfaction was similar across OS/UPR/APR groups (4.4 vs 4.3 vs 4.4). Complication risks were lower with percutaneous techniques. Conclusions During the COVID-19 pandemic, percutaneous trigger finger release facilitated swifter rehabilitation and reduced hospital visits versus open surgery. The percutaneous approaches demonstrated clear benefits especially relevant for strained healthcare systems, including neater post-operative recovery, diminished long-term discomfort, and lower complication risks. Percutaneous release has considerable advantages and merits wider embrace.