Salim N, Abdullah S, Sapuan J, Haflah N H M
Department of Orthopaedics and Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
J Hand Surg Eur Vol. 2012 Jan;37(1):27-34. doi: 10.1177/1753193411415343. Epub 2011 Aug 4.
We compared the effectiveness of physiotherapy and corticosteroid injection treatment in the management of mild trigger fingers. Mild trigger fingers are those with mild crepitus, uneven finger movements and actively correctable triggering. This is a single-centred, prospective, block randomized study with 74 patients; 39 patients for steroid injection and 35 patients for physiotherapy. The study duration was from Jun 2009 until August 2010. Evaluation was done at 6 weeks, 3 months and 6 months post-treatment. At 3 months, the success rate (absence of pain and triggering) for those receiving steroid injection was 97.4% and physiotherapy 68.6%. The group receiving steroid injection also had lower pain score, higher rate of satisfaction, stronger grip strength and early recovery to near normal function (findings were all significant, p < 0.05). At 6 months, only those who were successfully treated were further questioned on recurrence (presence of pain and triggering). Those who received corticosteroid injections had a significant recurrence rate of pain but not triggering. The physiotherapy group had no recurrence of pain or triggering due to the type of triggering responsive to physiotherapy or possibly due to awareness of physiotherapy exercises. Perhaps they were able to institute self-treatment on early onset of symptoms of trigger fingers. We conclude that corticosteroid injection has a better outcome compared to physiotherapy in the treatment of mild trigger fingers but physiotherapy may have a role in prevention of recurrence.
我们比较了物理治疗和皮质类固醇注射治疗在轻度扳机指治疗中的效果。轻度扳机指是指伴有轻度摩擦音、手指运动不均匀且主动可纠正扳机现象的情况。这是一项单中心、前瞻性、区组随机研究，共有74例患者；39例接受类固醇注射，35例接受物理治疗。研究时间从2009年6月至2010年8月。在治疗后6周、3个月和6个月进行评估。3个月时，接受类固醇注射者的成功率（无疼痛和扳机现象）为97.4%，物理治疗者为68.6%。接受类固醇注射的组疼痛评分更低、满意度更高、握力更强且功能恢复到接近正常的时间更早（所有结果均具有显著性，p<0.05）。6个月时，仅对成功治疗的患者进一步询问复发情况（疼痛和扳机现象的存在）。接受皮质类固醇注射者有明显的疼痛复发率，但无扳机现象复发。物理治疗组没有因对物理治疗有反应的扳机类型或可能由于对物理治疗锻炼的认知而出现疼痛或扳机现象复发。也许他们能够在扳机指症状早期就进行自我治疗。我们得出结论，在轻度扳机指的治疗中，皮质类固醇注射比物理治疗有更好的效果，但物理治疗可能在预防复发方面有作用。
