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腕管综合征手术后扳机指的发病:开放手术与内镜技术的评估

Onset of Trigger Finger after Carpal Tunnel Syndrome Surgery: Assessment of Open and Endoscopic Techniques.

作者信息

Fernandes Marcela, Belloti João Carlos, Okamura Aldo, Raduan Neto Jorge, Tajiri Rafael, Faloppa Flávio, Moraes Vinícius Ynoe de

机构信息

Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo, São Paulo, SP, Brasil.

Serviço de Cirurgia da Mão, Hospital Alvorada, Moema, São Paulo, SP, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2021 Jun;56(3):346-350. doi: 10.1055/s-0040-1721834. Epub 2021 Jul 1.

Abstract

The present study aimed to determine the frequency of trigger finger (TF) onset after surgery for carpal tunnel syndrome (CTS) using an open (OT) or an endoscopic technique (ET). As a secondary endpoint, the present study also compared paresthesia remission and residual pain rates in patients submitted to both techniques.  Trigger finger onset and remission rates of paresthesia and pain at the median nerve territory was verified prospectively in a series of adult patients submitted to an OT procedure (  = 34). These findings were compared with a retrospective cohort submitted to ET (  = 33) by the same surgical team. Patients were evaluated with a structured questionnaire in a return visit at least 6 months after surgery.  Sixty-seven patients were evaluated. There was no difference regarding trigger finger onset (OT, 26.5% versus ET, 27.3%;  = 0.94) and pain (OT, 76.5% versus ET, 84.8%;  = 0.38). Patients submitted to OT had fewer paresthesia complaints compared with those operated using ET (OT, 5.9% versus ET, 24.2%;  = 0.03).  In our series, the surgical technique did not influence trigger finger onset and residual pain rates. Patients submitted to OT had less complaints of residual postoperative paresthesia.

摘要

本研究旨在确定采用开放手术(OT)或内镜技术(ET)治疗腕管综合征(CTS)后扳机指(TF)的发病频率。作为次要终点,本研究还比较了接受这两种技术治疗的患者的感觉异常缓解率和残余疼痛率。前瞻性地验证了一系列接受OT手术的成年患者(n = 34)正中神经区域扳机指的发病情况以及感觉异常和疼痛的缓解率。这些结果与同一手术团队进行的ET手术的回顾性队列(n = 33)进行了比较。患者在术后至少6个月的回访中通过结构化问卷进行评估。共评估了67例患者。扳机指的发病情况(OT组为26.5%,ET组为27.3%;P = 0.94)和疼痛情况(OT组为76.5%,ET组为84.8%;P = 0.38)没有差异。与接受ET手术的患者相比,接受OT手术的患者感觉异常的主诉较少(OT组为5.9%,ET组为24.2%;P = 0.03)。在我们的研究系列中,手术技术不影响扳机指的发病情况和残余疼痛率。接受OT手术的患者术后残余感觉异常的主诉较少。

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本文引用的文献

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Relationship of Carpal Tunnel Release and New Onset Trigger Finger.腕管松解术与新发扳机指的关系
J Hand Surg Am. 2019 Jan;44(1):28-34. doi: 10.1016/j.jhsa.2018.10.003. Epub 2018 Nov 6.
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Does the presence of trigger finger affect the outcome of surgical treatment of carpal tunnel syndrome? A preliminary prognostic study.
J Hand Surg Eur Vol. 2018 Nov;43(9):999-1001. doi: 10.1177/1753193418793770. Epub 2018 Aug 22.
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Rev Bras Ortop. 2014 Aug 23;49(5):437-45. doi: 10.1016/j.rboe.2014.08.002. eCollection 2014 Sep-Oct.
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Cochrane Database Syst Rev. 2008 Oct 8;2008(4):CD001552. doi: 10.1002/14651858.CD001552.pub2.
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Trigger digits: principles, management, and complications.扳机指:原理、治疗及并发症
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