Flensted Frederik, Jensen Claus Hjorth, Daugaard Henrik, Vedel Jens-Christian, Jørgensen Rasmus Wejnold
Department of Orthopedics, Hand Clinic, Herlev-Gentofte University Hospital of Copenhagen, Copenhagen, Denmark.
Department of Orthopedics, Herlev-Gentofte University Hospital of Copenhagen, Copenhagen, Denmark.
J Hand Microsurg. 2021 Apr;13(2):109-113. doi: 10.1055/s-0040-1719228. Epub 2020 Oct 29.
The aim of the study was to estimate recurrence rates, time to recurrence, and predisposing factors for recurrence of trigger finger when treated with corticosteroid (CS) injection as primary treatment. In a retrospective chart review, we identified primary trigger fingers treated with CS injection as primary treatment. Affected hand and finger, recurrence, time to recurrence, duration of symptoms, secondary treatment type, and comorbidities were recorded. A total of 539 patients were included with a mean follow-up of 47.6 months In total, 330/539 (61%) recurrences were registered. Mean time to recurrence was 312 days. Increased risk of recurrence was seen after treatment of the third finger (relative risk [RR]: 1.22; 95% confidence interval [CI]: 1.06-1.39). Several comorbidities were associated with increased risk of recurrence: carpal tunnel syndrome (RR: 1.27; 95% CI: 1.07-1.52), thyroid disease (RR: 1.45; 95% CI: 1.15-1.83), or shoulder diseases (RR: 1.58; 95% CI: 1.36-1.83). We found a recurrence rate after primary treatment of CS injection for trigger finger of 61%. Most recurrences happened within 2 years and we found treatment of third finger, carpal tunnel syndrome, shoulder, or thyroid disease to be associated with an increased risk of recurrence of symptoms.
本研究的目的是评估以皮质类固醇(CS)注射作为主要治疗方法时扳机指的复发率、复发时间和复发的诱发因素。
在一项回顾性病历审查中,我们确定了以CS注射作为主要治疗方法的原发性扳机指。记录受影响的手和手指、复发情况、复发时间、症状持续时间、二次治疗类型和合并症。共纳入539例患者,平均随访47.6个月。
总共记录到330/539例(61%)复发。平均复发时间为312天。治疗第三指后复发风险增加(相对风险[RR]:1.22;95%置信区间[CI]:1.06 - 1.39)。几种合并症与复发风险增加相关:腕管综合征(RR:1.27;95%CI:1.07 - 1.52)、甲状腺疾病(RR:1.45;95%CI:1.15 - 1.83)或肩部疾病(RR:1.58;95%CI:1.36 - 1.83)。
我们发现,以CS注射作为主要治疗方法治疗扳机指后的复发率为61%。大多数复发发生在2年内,并且我们发现治疗第三指、腕管综合征、肩部或甲状腺疾病与症状复发风险增加相关。