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手术治疗与非手术治疗腕管综合征中扳机指的发病率

Incidence of Trigger Finger in Surgically and Nonsurgically Managed Carpal Tunnel Syndrome.

作者信息

Wessel Lauren E, Gu Alex, Asadourian Paul, Stepan Jeffrey G, Fufa Duretti T, Osei Daniel A

机构信息

Department of Orthopedic Surgery, University of California Los Angeles, Santa Monica, CA.

Department of Orthopedic Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC.

出版信息

J Hand Surg Glob Online. 2022 Nov 24;5(2):164-168. doi: 10.1016/j.jhsg.2022.10.017. eCollection 2023 Mar.

Abstract

PURPOSE

The purpose of this study was to determine whether extremities undergoing carpal tunnel release (CTR) have an increased rate of trigger finger (TF) compared with conservatively managed carpal tunnel syndrome.

METHODS

Data were collected from the Humana Insurance Database, and subjects were chosen on the basis of a history of CTR with propensity matching performed to develop a nonsurgical cohort. Following propensity matching, 16,768 patients were identified and equally split between surgical and nonsurgical treatments. Demographic information and medical comorbidities were recorded. Univariate and multivariate analyses were performed to identify risk factors for the development of TF within 6 months of carpal tunnel syndrome diagnosis.

RESULTS

Patients in the surgical cohort were more likely to develop TF than those in the nonsurgical cohort whether in the ipsilateral or contralateral extremity. Whether managed surgically or nonsurgically, extremities with carpal tunnel syndrome demonstrated an increased prevalence of TF than their contralateral, unaffected extremity.

CONCLUSIONS

Surgeons should be aware of the association of TF and CTR both during the presurgical and postsurgical evaluations as they might impact patient management. With knowledge of these data, surgeons may be more attuned to detecting an early TF during the postsurgical period and offer more aggressive treatment of TF pathology during CTR.

TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic III.

摘要

目的

本研究旨在确定与保守治疗的腕管综合征相比,接受腕管松解术(CTR)的肢体发生扳机指(TF)的几率是否更高。

方法

从Humana保险数据库收集数据,并根据CTR病史选择受试者,通过倾向匹配法建立非手术队列。倾向匹配后,确定了16768例患者,并将其平均分为手术治疗组和非手术治疗组。记录人口统计学信息和合并症。进行单因素和多因素分析,以确定腕管综合征诊断后6个月内发生TF的危险因素。

结果

无论同侧还是对侧肢体,手术队列中的患者比非手术队列中的患者更易发生TF。无论采用手术还是非手术治疗,患有腕管综合征的肢体比其对侧未受影响的肢体TF患病率更高。

结论

外科医生在术前和术后评估时均应注意TF与CTR的关联,因为它们可能会影响患者的治疗。了解这些数据后,外科医生可能会更关注术后早期TF的检测,并在CTR期间对TF病变采取更积极的治疗措施。

研究类型/证据水平:预后性III级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a4e/10039288/81ac3151c602/gr1.jpg

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