Patel M R, Bassini L
Division of Orthopedic Surgery, Maimonides Medical Center, Brooklyn, N.Y.
J Hand Surg Am. 1992 Jan;17(1):110-3. doi: 10.1016/0363-5023(92)90124-8.
Fifty trigger fingers were treated by splinting of the metacarpophalangeal joint at 10 to 15 degrees of flexion for an average of 6 weeks (range, 3 to 9 weeks). Another 50 trigger fingers were injected with 0.5 ml of betamethasone sodium phosphate and acetate suspension (Celestone) and 0.5 ml of lidocaine. All patients were followed up for a minimum of 1 year (range, 1 to 4 years). Treatment was successful in 33 (66%) of the splinted digits and 42 (84%) of the injected digits. Fifty percent of the 10 splinted thumbs and 70% of the 40 splinted fingers had a successful outcome. Of the 17 unsuccessfully treated digits in the splinted group, 15 were later cured with injections and 2 required surgery. All of the 7 unsuccessfully treated digits in the injected group were cured with surgery. Patients with marked triggering, symptoms of more than 6 months' duration, and multiple involved digits had a higher rate of failure in both groups. Splinting offers an alternative for patients who have a strong objection to cortisone injection.
50例扳机指患者采用掌指关节屈曲10至15度的夹板固定治疗，平均固定6周（范围为3至9周）。另外50例扳机指患者注射了0.5毫升倍他米松磷酸钠和醋酸酯混悬液（得宝松）以及0.5毫升利多卡因。所有患者至少随访1年（范围为1至4年）。夹板固定治疗的手指中有33例（66%）治疗成功，注射治疗的手指中有42例（84%）治疗成功。10例夹板固定的拇指中有50%、40例夹板固定的手指中有70%获得了成功的治疗结果。在夹板固定组中17例治疗失败的手指中，15例后来通过注射治愈，2例需要手术治疗。注射组中7例治疗失败的手指均通过手术治愈。两组中扳机症状明显、症状持续时间超过6个月以及多个手指受累的患者失败率较高。对于强烈反对皮质类固醇注射的患者，夹板固定提供了一种替代方法。
