From the Andrews Sports Medicine and Orthopedic Center, Birmingham, Alabama (REC); Department of Physical Medicine and Rehabilitation, University of Alabama School of Medicine, Birmingham, Alabama (JP); and American Sports Medicine Institute, Birmingham, Alabama (GF, MD).
Am J Phys Med Rehabil. 2020 Dec;99(12):1150-1156. doi: 10.1097/PHM.0000000000001510.
Trigger finger at the A1 pulley is a common cause of hand pain leading to functional limitations. This study evaluated the outcomes of patients treated with a microinvasive ultrasound-guided trigger finger release technique using an 18 blade and described three tests that confirm a complete release.
A retrospective chart review and cross-sectional study of 46 cases of A1 pulley trigger finger releases in 28 patients performed at a private, sports medicine clinic using this technique were completed, meeting power criteria. The primary outcome measure was the resolution of mechanical catching/locking; secondary outcome measures were reduction in visual analog scale for pain and improvement of function in the modified Nirschl scale.
Complete release was achieved in all patients, with no recurrence of catching/locking during the first year (P < 0.0001). Ninety-eight percent of patients had significant pain and functional improvement (P < 0.0001). There were no complications perioperatively and postoperatively. The three confirmatory tests ensured that all cases obtained a successful outcome.
This technique combined with confirmatory tests resulted in full resolution of the locking for all patients and statistically significant reduction in pain and improvement in function.
A1 滑车扳机指是导致手部疼痛和功能受限的常见原因。本研究评估了采用 18 刀片微创超声引导扳机指松解术治疗 A1 滑车扳机指的患者的结局，并描述了三种可确认完全松解的测试。
在一家私人运动医学诊所，对 28 名符合动力标准的患者的 46 例 A1 滑车扳机指松解术进行了回顾性图表分析和横断面研究。主要结局测量指标是机械性卡锁/锁定的解决程度；次要结局测量指标是疼痛视觉模拟评分的降低和改良 Nirschl 评分的功能改善。
所有患者均实现了完全松解，在第 1 年内无再次卡锁/锁定的复发（P < 0.0001）。98%的患者疼痛和功能显著改善（P < 0.0001）。围手术期和术后均无并发症。这三种确认性测试确保了所有病例都获得了成功的结局。
这种技术结合确认性测试，使所有患者的锁定均完全解决，疼痛显著减轻，功能明显改善，具有统计学意义。
