Department of Ultrasonic, Sichuan Academy of Medical Sciences & Sichuan Provincal People's Hospital, School of Medicine, University of Electronic Scienceand Technology of China, No. 32, West Second Section, First Ring Road, Qingyang District, Chengdu, 610072, Sichuan, China.
BMC Surg. 2022 Jun 7;22(1):221. doi: 10.1186/s12893-022-01665-1.
The purpose of the present study was to evaluate the clinical effectiveness of ultrasonography-guided needle release of A1 pulley combined with corticosteroid injection by comparing it with ultrasound-guided needle release of the A1 pulley alone.
A total of 49 patients (55 fingers, thumb) with trigger fingers were included in this retrospective study. Twenty-seven fingers were treated with ultrasound-guided needle release of the A1 pulley alone (monotherapy group), and 28 fingers were treated with needle release of the A1 pulley combined with corticosteroid injection (combination group). Visual analog scale (VAS), Froimson scale, postoperative recurrence rate, and thickness of A1 pulley at baseline, Week-2, Week-12, and Month-6 were recorded.
Higher clinical cure rates were observed in the combination group at Week-2 after treatment among patients with the Froimson scale Grade III and IV (p < 0.05). Among Froimson scale Grade IV patients, the combination group had a significantly thinner thickness of A1 pulley and better articular pain relief at Week-2 (all p < 0.05). No significant differences were found in the clinical cure rate, the thickness of the A1 pulley, articular pain relief, and recurrence rate between the two groups at Week-12 and Month-6 (all p > 0.05).
Ultrasonography-guided needle release of A1 pulley plus corticosteroid injection was superior to ultrasonography-guided A1 pulley needle release alone during early-stage treatment of severe patients with trigger fingers. Moreover, ultrasonography-guided A1 pulley needle release combined with corticosteroid injection narrows the thickness of the A1 pulley. It is necessary to carry out preoperative evaluation and individualized treatment for patients of various severities.
本研究旨在通过比较超声引导下 A1 滑车松解联合皮质类固醇注射与单纯超声引导下 A1 滑车松解,评估 A1 滑车松解治疗扳机指的临床疗效。
回顾性分析 49 例(55 指,拇指)扳机指患者的临床资料。27 指接受单纯超声引导下 A1 滑车松解(单纯组),28 指接受超声引导下 A1 滑车松解联合皮质类固醇注射(联合组)。记录两组患者的视觉模拟评分(VAS)、Froimson 评分、术后复发率以及 A1 滑车厚度(基线、治疗后 2 周、12 周和 6 个月)。
治疗后 2 周,Froimson 评分Ⅲ、Ⅳ级患者中,联合组的临床治愈率高于单纯组(p<0.05)。Froimson 评分Ⅳ级患者中,联合组 A1 滑车厚度较单纯组薄,关节疼痛缓解更明显,差异均有统计学意义(均 p<0.05)。两组患者在治疗后 12 周和 6 个月时的临床治愈率、A1 滑车厚度、关节疼痛缓解程度和复发率比较,差异均无统计学意义(均 p>0.05)。
对于重度扳机指患者,超声引导下 A1 滑车松解联合皮质类固醇注射在早期治疗中优于单纯超声引导下 A1 滑车松解。此外,超声引导下 A1 滑车松解联合皮质类固醇注射可缩小 A1 滑车厚度。对于不同严重程度的患者,需要进行术前评估并进行个体化治疗。