Lin Fu-Yu, Wu Chao-I, Cheng Hsu-Tang
a Department of Neurology , China Medical University Hospital, China Medical University School of Medicine , Taichung City , Taiwan.
b Division of Plastic and Reconstructive Surgery, Department of Surgery , China Medical University Hospital, China Medical University School of Medicine , Taichung City , Taiwan.
J Plast Surg Hand Surg. 2018 Apr;52(2):67-73. doi: 10.1080/2000656X.2017.1345751. Epub 2017 Jul 7.
Carpal tunnel syndrome (CTS) and trigger digits are among the most common nontraumatic hand disorders treated by plastic surgeons. The onset of trigger digits after carpal tunnel release (CTR) has been inconsistently reported. This systematic review assessed the prevalence of trigger digits development in patients after CTR surgery.
We searched the MEDLINE, EMBASE and SCOPUS databases for papers published between January 1966 and August 2016. Eligible studies contained quantitative data on the incidence of trigger digits after CTR. The primary outcome measure was the onset of trigger digits after CTR. The secondary outcome measure was the prevalence of digital involvement in patients who developed trigger digits after CTR.
A total of 5654 CTR surgeries were performed in the included nine studies, and 483 patients (8.5%) developed trigger digits after CTR. The reported incidence of trigger digits after CTR ranged from 5.2% to 31.7%. The time to development of trigger digits was approximately 6 months postoperatively. In the eight observational studies and in the randomized controlled trial, the thumb and ring finger were reported as the most commonly involved trigger digits, respectively.
The incidence of trigger digits after CTR surgery is not negligible. Thumbs and ring fingers are the most commonly involved digits. This topic should therefore be suitably addressed during preoperative consultations.
腕管综合征（CTS）和扳机指是整形外科医生治疗的最常见的非创伤性手部疾病。腕管松解术（CTR）后扳机指的发病情况报道不一。本系统评价评估了CTR手术后患者扳机指发生的患病率。
我们检索了MEDLINE、EMBASE和SCOPUS数据库中1966年1月至2016年8月发表的论文。符合条件的研究包含CTR后扳机指发病率的定量数据。主要结局指标是CTR后扳机指的发病情况。次要结局指标是CTR后发生扳机指的患者手指受累的患病率。
纳入的9项研究共进行了5654例CTR手术，483例患者（8.5%）在CTR后发生扳机指。报道的CTR后扳机指发病率在5.2%至31.7%之间。扳机指出现的时间约为术后6个月。在8项观察性研究和随机对照试验中，拇指和无名指分别被报道为最常受累的扳机指。
CTR手术后扳机指的发病率不可忽视。拇指和无名指是最常受累的手指。因此，在术前咨询中应适当提及这个问题。
