Kuczmarski Alexander S, Harris Andrew P, Gil Joseph A, Weiss Arnold-Peter C
Department of Orthopaedics, Alpert Medical School of Brown University, Providence, RI.
Department of Orthopaedics, Alpert Medical School of Brown University, Providence, RI.
J Hand Surg Am. 2019 Feb;44(2):150-153. doi: 10.1016/j.jhsa.2018.03.045. Epub 2018 May 16.
Diabetics have a much greater prevalence of trigger finger than nondiabetics and are more likely to have severe symptoms. Diabetic trigger finger may be more accurately described on a spectrum of diabetic hand pathology alongside carpal tunnel syndrome and cheiroarthropathy. Recent publications have called into question the current treatment algorithm for diabetic trigger finger. Although some evidence supports the use of corticosteroid injections, a recent cost analysis reported that immediate surgical release of the A1 pulley in the clinic is the most cost-effective management of diabetic trigger finger. In addition to traditional treatment with injection and open release, percutaneous release with or without simultaneous corticosteroid injection has shown promising results and may have a role in patient care. The appropriate treatment algorithm in terms of efficacy, safety, and cost remains controversial.
糖尿病患者扳机指的患病率远高于非糖尿病患者，且更易出现严重症状。糖尿病性扳机指可能更准确地被描述为糖尿病手部病变谱中的一种，与腕管综合征和糖尿病手关节病并存。最近的出版物对目前糖尿病性扳机指的治疗方案提出了质疑。尽管有一些证据支持使用皮质类固醇注射，但最近的一项成本分析报告称，在门诊立即手术松解A1滑车是糖尿病性扳机指最具成本效益的治疗方法。除了传统的注射和切开松解治疗外，无论是否同时注射皮质类固醇的经皮松解已显示出有前景的结果，并且可能在患者治疗中发挥作用。在疗效、安全性和成本方面的合适治疗方案仍存在争议。
