Xie Peng, Zhang Qi-Hao, Zheng Gui-Zhou, Liu De-Zhong, Miao Hou-Guang, Zhang Wei-Fang, Ye Jian-Feng, Du Shi-Xin, Li Xue-Dong
Department of Orthopedics, The Third Affiliated Hospital (The Affiliated Luohu Hospital) of Shenzhen University, 518000, Shenzhen, Guangdong, China.
Department of Emergency, First Affiliated Hospital, Shantou University Medical College, 515041, Shantou, Guangdong, China.
Orthopade. 2019 Mar;48(3):202-206. doi: 10.1007/s00132-018-03676-4.
The purpose of this study was to evaluate the effectiveness of conventional open surgery and percutaneous release with a specially designed needle for treating stenosing tenosynovitis in terms of cure, relapse and complication rates.
In this study 89 fingers from 76 patients were randomly assigned and allocated to one of the treatment groups. A total of 37 patients were treated with open surgery in group 1 and 39 patients with percutaneous release using a specially designed needle in group 2. A patient-based 4-inch visual analogue scale (VAS), Quinnell grading (QG), disability of arm shoulder and hand (DASH) score and finger total joint range of motion (FTROM) score were evaluated before treatment and after 7, 30 and 180 days. When finger QG scores were equal or greater than 2 points at follow-up at 180 days this was defined as recurrence..
There were no significant differences between the two groups (P > 0.05) in terms of VAS, DASH and QG scores and the degree of FTROM. At 7 days all the data were significantly different (p < 0.05) compared with preoperative data, 30 days was significantly different (p < 0.05) compared with 7 days while at 180 days no significant differences could be found (p > 0.05) compared with 30 days. The recurrence rate in group 1 was 4.65% and 6.55% in group 2.
The percutaneous release and open surgery methods displayed similar effectiveness regarding the cure and recurrence of trigger finger disorder. The use of a specially designed needle for release is a safe and reliable method.
本研究旨在从治愈率、复发率和并发症发生率方面评估传统开放手术和使用特制针经皮松解治疗狭窄性腱鞘炎的有效性。
本研究将76例患者的89根手指随机分配到其中一个治疗组。第1组37例患者接受开放手术治疗，第2组39例患者使用特制针进行经皮松解治疗。在治疗前以及治疗后7天、30天和180天评估基于患者的4英寸视觉模拟量表（VAS）、奎内尔分级（QG）、手臂、肩部和手部功能障碍（DASH）评分以及手指总关节活动范围（FTROM）评分。当180天随访时手指QG评分等于或大于2分时定义为复发。
两组在VAS、DASH和QG评分以及FTROM程度方面无显著差异（P>0.05）。与术前数据相比，7天时所有数据均有显著差异（p<0.05），与7天时相比，30天时显著不同（p<0.05），而与30天时相比，180天时未发现显著差异（p>0.05）。第1组的复发率为4.65%，第2组为6.55%。
经皮松解和开放手术方法在扳机指疾病的治愈和复发方面显示出相似的有效性。使用特制针进行松解是一种安全可靠的方法。
