Womack M E, Ryan J C, Shillingford-Cole V, Speicher S, Hogue G D
Department of Orthopaedic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States.
J Child Orthop. 2018 Jun 1;12(3):209-217. doi: 10.1302/1863-2548.12.180058.
Paediatric trigger finger (PTF) is a rare condition as seen by the lack of studies published about paediatric populations. Due to this general lack of information, the steps to employ to correct this disorder, whether surgically or non-surgically, have not yet reached consensus status. The objective of this study is to review the published literature regarding treatment options for PTF in order to develop a proposed step-wise treatment algorithm for children presenting with trigger finger.
A systematic review of the literature was conducted on PubMed to locate English language studies reporting on treatment interventions of PTF. Data was collected on number of patients/fingers seen in the study, the category of the fingers involved, the number of patients/fingers undergoing each intervention and reported outcomes.
Seven articles reporting on 118 trigger fingers were identified. In all, 64 fingers were treated non-surgically, with 57.8% (37/64) resolving. In all, 54 fingers were initially surgically treated, with 87% (47/54) resolving. In total, 34 fingers did not have resolution of symptoms following primary treatment, and 27 fingers received follow-up treatment, with 92.6% (25/27) resolving. Overall, 92.4% (109/118) of fingers achieved resolution of symptoms after all treatments were completed.
Limitations for this study included few prospective studies and small sample sizes. This is likely due to the rarity of PTF. This review of the literature indicated that a step-wise approach, including non-operative and surgical techniques, should be employed in the management of PTF.
This work meets the requirements of the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses).
小儿扳机指（PTF）是一种罕见病症，关于小儿群体的相关研究发表较少。由于普遍缺乏这方面的信息，无论是手术治疗还是非手术治疗来纠正这种疾病的步骤尚未达成共识。本研究的目的是回顾已发表的关于小儿扳机指治疗选择的文献，以便为患有扳机指的儿童制定一个建议的逐步治疗方案。
在PubMed上对文献进行系统回顾，以查找报道小儿扳机指治疗干预措施的英文研究。收集的数据包括研究中观察到的患者/手指数量、受累手指的类别、接受每种干预的患者/手指数量以及报告的结果。
共识别出7篇报道118例扳机指的文章。其中，64根手指接受了非手术治疗，57.8%（37/64）症状缓解。共有54根手指最初接受了手术治疗，87%（47/54）症状缓解。总共有34根手指在初次治疗后症状未缓解，27根手指接受了后续治疗，92.6%（25/27）症状缓解。总体而言，所有治疗完成后，92.4%（109/118）的手指症状得到缓解。
本研究的局限性包括前瞻性研究较少和样本量较小。这可能是由于小儿扳机指的罕见性。对文献的回顾表明，在小儿扳机指的管理中应采用包括非手术和手术技术在内的逐步方法。
证据级别III：本研究符合PRISMA指南（系统评价和Meta分析的首选报告项目）的要求。
