Department of General Practice, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Rehabilitation Medicine, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands.
Arch Phys Med Rehabil. 2010 Feb;91(2):298-314. doi: 10.1016/j.apmr.2009.09.023.
To provide an evidence-based overview of the effectiveness of conservative and surgical interventions for trigger finger, Dupuytren's, and De Quervain's diseases.
The Cochrane Library, PEDro, PubMed, Embase, and CINAHL were searched to identify relevant studies.
Two reviewers independently applied the inclusion criteria to select potential relevant studies from the title and abstracts of the references retrieved by the literature search. Relevant (Cochrane) reviews and randomized controlled trials (RCTs) were included.
Two reviewers independently extracted the data and performed a methodologic quality assessment.
A best-evidence synthesis was performed to summarize the results of the included trials. One Cochrane review (trigger finger) and 13 RCTs (trigger finger [6], Dupuytren's [4], De Quervain's [3]) were included. The trials reported on physiotherapy (De Quervain's), steroid injections (trigger finger, De Quervain's), surgical treatment (trigger finger, De Quervain's), and a postsurgical treatment (Dupuytren's). For trigger finger, moderate evidence was found for the effectiveness of steroid injections in the short-term (1-4 wk) but not for long-term outcomes. Limited evidence was found for the effectiveness of staples compared with sutures in skin closure and for intermittent compression after surgery to treat Dupuytren's disease. For other interventions, no evidence was found.
Indications for effectiveness of some interventions for trigger finger, Dupuytren's, and De Quervain's diseases were found. Because only a few RCTs were identified, it is difficult to draw firm conclusions. High-quality RCTs are clearly needed in this field.
提供循证医学综述，评估扳机指、掌腱膜挛缩和桡骨茎突狭窄性腱鞘炎保守和手术干预的效果。
对 Cochrane 图书馆、PEDro、PubMed、Embase 和 CINAHL 进行检索，以确定相关研究。
两名审查员独立应用纳入标准，从检索到的参考文献的标题和摘要中筛选出潜在相关的研究。纳入了相关（Cochrane）综述和随机对照试验（RCT）。
两名审查员独立提取数据并进行方法学质量评估。
采用最佳证据综合方法总结纳入试验的结果。一项 Cochrane 综述（扳机指）和 13 项 RCT（扳机指[6]、掌腱膜挛缩[4]、桡骨茎突狭窄性腱鞘炎[3]）被纳入。这些试验报告了物理治疗（桡骨茎突狭窄性腱鞘炎）、类固醇注射（扳机指、桡骨茎突狭窄性腱鞘炎）、手术治疗（扳机指、桡骨茎突狭窄性腱鞘炎）和术后治疗（掌腱膜挛缩）。对于扳机指，短期（1-4 周）注射类固醇的效果有中等证据，但长期效果没有证据。有限的证据表明，与缝线相比，缝合皮肤时使用订书钉以及术后间歇性压迫治疗掌腱膜挛缩更有效。对于其他干预措施，没有证据。
发现了一些干预措施治疗扳机指、掌腱膜挛缩和桡骨茎突狭窄性腱鞘炎的有效性的适应症。由于只确定了少数 RCT，因此难以得出明确的结论。该领域显然需要高质量的 RCT。
