Department of Orthopedic Surgery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Trauma Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
J Hand Surg Asian Pac Vol. 2021 Jun;26(2):207-213. doi: 10.1142/S2424835521500193.
Primary treatment of trigger digits is conservative including stretching, night splinting and combination of heat and ice. When these methods fail, invasive methods such as corticosteroid injection, percutaneous release and open surgery are used. The purpose of this study is to compare the efficacy of two outpatient methods of percutaneous trigger finger release (PTFR) and corticosteroid injection (CI). This study is a randomized clinical trial that was performed with 6-month follow up. A total of 83 patients with trigger finger treated either with corticosteroid injection (n:40) or percutaneous release of the A1 pulley (n:43) were enrolled in this study. Demographic data were recorded before intervention. Pain score (VAS criterion), disease stage (Quinnell criteria), patient satisfaction and complications such as paresthesia, scarring, and stiffness (decrease in the range of motion) were recorded after the intervention. We used SPSS program (statistical package for the social science SPSS version 16) to perform the analysis. There were 18 male (21.7%) and 65 female (78.3%) patients, whose mean age was 52.54 ± 11.45 (28-85) years. There was a significant difference between the degree of pain at the time of the third, sixth weeks and sixth months in two groups. The degree of pain was lower in the CI group in the third and sixth weeks but it was lower in the PTFR group in the sixth month. Satisfaction of the patients in the sixth month was significantly higher in the PTFR group. The incidence of stiffness was also significantly lower in the PTFR group in the sixth month. Patients in PTFR group had greater recovery and satisfaction level and lower recurrence rate and pain. Therefore PTFR may be used as a substitute for CI in the treatment of trigger finger from the beginning especially in patients who do not want to have open surgery.
扳机指的主要治疗方法是保守治疗，包括拉伸、夜间夹板固定以及热疗和冰敷的联合应用。如果这些方法无效，则采用有创方法，如皮质类固醇注射、经皮松解和开放性手术。本研究旨在比较两种门诊经皮扳机指松解术（PTFR）和皮质类固醇注射（CI）的疗效。本研究是一项随机临床试验，随访时间为 6 个月。共有 83 例扳机指患者接受皮质类固醇注射（n=40）或 A1 滑车经皮松解术（n=43）治疗，纳入本研究。在干预前记录人口统计学数据。在干预后记录疼痛评分（VAS 标准）、疾病阶段（Quinnell 标准）、患者满意度以及感觉异常、瘢痕形成和僵硬（运动范围减小）等并发症。我们使用 SPSS 程序（统计软件包 for the social science SPSS 版本 16）进行分析。有 18 名男性（21.7%）和 65 名女性（78.3%），平均年龄为 52.54±11.45（28-85）岁。两组在第三、第六周和第六个月时的疼痛程度有显著差异。CI 组在第三和第六周时疼痛程度较低，但 PTFR 组在第六个月时疼痛程度较低。PTFR 组患者在第六个月时的满意度显著更高。PTFR 组在第六个月时僵硬的发生率也显著较低。PTFR 组患者的恢复和满意度水平更高，复发率和疼痛程度更低。因此，PTFR 可作为 CI 的替代治疗方法，尤其是在那些不想接受开放性手术的患者中。
