Clinical Medical College, Yangzhou University, Jiangsu Province, Yangzhou, 225009, China.
Department of Foot and Hand Surgery, Northern Jiangsu People's Hospital, Jiangsu Province, Yangzhou, 225001, China.
Int Orthop. 2022 Dec;46(12):2853-2857. doi: 10.1007/s00264-022-05573-0. Epub 2022 Sep 10.
To study the efficacy of three kinds of surgery for trigger thumb.
A total of 60 cases of trigger thumb (Quinnell Grade IV) were randomly divided into three groups. The A1 pulley was disconnected at the middle in Group A, at the extreme radial side in Group B, excised in Group C. The following indicators were recorded pre-operatively (D0), and at one (D1), three (D3), seven (D7), 14 (D14), and 28 (D28) days post-operatively: 1. the pain visual analogue score (VAS) when flexing the affected thumb; 2. range of motion (ROM) of the interphalangeal joint with pain tolerance; 3. the time of pain disappearance when flexing the affected thumb.
The differences of VAS and ROM between D1 and D0, D3 and D1, D7 and D3, D14 and D7, D28 and D14 were statistically significant (P < 0.05). There was no significant difference in changes of VAS (or ROM) at D1 or D28 in contrast to D0 among the three groups. The differences of VAS (or ROM) changes at D3, D7, and D14 in contrast to D0 among the three groups were statistically significant (P < 0.05). The difference of the time when the pain disappearing in the normal range of motion among the three groups were statistically significant (P < 0.05).
Disconnecting the A1-pulley at the extreme radial side is better than another two methods for treating the trigger thumb (Quinnell Grade IV). It has been shown to effectively accelerate postoperative pain relief and functional recovery.
Clinical trial registry number: ChiCTR2100051193.
研究三种扳机指手术的疗效。
将 60 例（Quinnell Ⅳ级）扳机指患者随机分为三组，A 组在 A1 滑车中部切断，B 组在极度桡侧切断，C 组切除。记录术前（D0）、术后 1 天（D1）、3 天（D3）、7 天（D7）、14 天（D14）和 28 天（D28）以下指标：1. 屈患指时疼痛视觉模拟评分（VAS）；2. 有痛活动度；3. 屈患指时疼痛消失时间。
D1 与 D0、D3 与 D1、D7 与 D3、D14 与 D7 及 D28 与 D14 时 VAS 和 ROM 比较差异有统计学意义（P<0.05），D1 及 D28 时与 D0 时三组间 VAS（或 ROM）改变比较差异无统计学意义；D3、D7 及 D14 时与 D0 时三组间 VAS（或 ROM）改变比较差异有统计学意义（P<0.05）；三组间疼痛消失至正常活动范围时间的差异有统计学意义（P<0.05）。
在 A1 滑车极度桡侧切断优于另外两种方法治疗扳机指（Quinnell Ⅳ级），能有效加快术后疼痛缓解和功能恢复。
ChiCTR2100051193。
