Finger Lacerations Are Highly Prevalent Among Shoulder Surgeons, and No Widely Effective Preventive Measures Are Available

Purpose To explore factors associated with the occurrence of finger lacerations during arthroscopic and open knot‐tying techniques in shoulder surgery. Methods This cross‐sectional survey was conducted at an international shoulder surgery course in March 2024. Attending shoulder surgeons performing arthroscopic and open shoulder surgeries were asked to participate in a survey on site using a structured questionnaire to explore factors associated with the occurrence and anatomical distribution of skin lacerations during arthroscopic and open knot‐tying techniques. Demographic, procedural, and intraoperative variables were collected and compared between techniques. Linear and logistic regression analyses were performed to identify predictors of laceration occurrence and severity. Results A total of 100 surgeons were invited to participate, all of whom completed the survey (response rate: 100%). Eighty‐nine percent of respondents reported having experienced finger lacerations either currently or in the past, with 79% still affected at the time of the survey. The remaining 10% had adopted effective preventive measures: 3% modified their knot‐tying technique, 2% wrapped tape around the affected fingers, and 5% developed hyperkeratosis as a protective adaptation. Among those affected, lacerations were reported to occur always in 20%, often in 42%, sometimes in 22%, and rarely in 16% of arthroscopic cases. The distal interphalangeal joints of the index and little fingers were most commonly involved, with the index finger affected in 71%, the little finger in 30%, and 18% reporting lesions on both fingers. Rotator cuff reconstruction was the procedure most frequently associated with laceration occurrence; however, no significant correlation was found between laceration frequency and the number of reconstructions performed per year ( r = 0.091, P = .371). Similarly, no association was observed between handedness and the affected side, with 43% reporting bilateral involvement ( χ 2 = 2.464, P = .292). Hyperkeratosis was observed in 54.4% of affected surgeons, suggesting a potential adaptive response to repetitive skin trauma. Conclusions Finger lacerations are a common problem among shoulder surgeons. Seventy‐nine percent of respondents reported being regularly affected, particularly at the distal interphalangeal joint of the index and little fingers. Surgeons performing rotator cuff repairs showed a significantly higher incidence of finger lacerations at present. Clinical Relevance Finger lacerations and glove microlesions during knot tying are common among shoulder surgeons and may compromise barrier integrity. The lack of widely effective preventive measures underscores the need for improved strategies to protect both surgeons and patients.