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新型超声引导经皮治疗腕管和扳机指疾病的设备的前瞻性评估。sono-instruments® 的疗效和安全性。

Prospective evaluation of a novel device for ultrasound-guided percutaneous treatment of carpal tunnel and trigger finger disease. Efficacy and safety of sono-instruments®.

机构信息

Department of Orthopedics and Traumatology, Université Libre de Bruxelles, Erasme University Hospital, Brussels, Belgium.

Clinique du Sport, 36 boulevard saint marcel, 75005, Paris, France.

出版信息

J Ultrasound. 2024 Dec;27(4):873-885. doi: 10.1007/s40477-023-00851-y. Epub 2024 Apr 10.

Abstract

PURPOSE

To evaluate the safety and effectiveness of percutaneous release procedures under sonography using Sono-Instruments® in the treatment of carpal tunnel syndrome (CTS) and trigger finger (TF).

METHODS

Prospective study involving 30 patients, divided into two groups (15 CTS, and 15 TF). The primary outcomes were surgical performance-related outcomes (visibility, ease of use, satisfaction, duration) using Sono-Instruments® and patient-related outcomes (pain, activity limitations, time to return to work, functional scores). Secondary outcomes included complications. Patients were followed for two months post-operatively.

RESULTS

In the CTS group, the average age of the patients was 58.7 years. The percutaneous release of the transverse carpal ligament was effectively completed in all cases, with excellent device performance and no adverse events. At one week, all patients could wash their hands, 80% could perform activities of daily living, and 80% of those working had returned to their activities. At two months, all patients had resumed all activities. Pillar pain was still present in 53.3%. In the TF group, the patients had an average age of 57.9 years. The percutaneous release of the A1 annular pulley was successful in all cases, with excellent device performance and no adverse events. At one week, all patients could wash their hands, 93.3% could do all activities of daily living, and 75% of those working were back to their professional activities. At two months, all patients were back to all activities of daily living and work. The DASH score was significantly improved at two months, compared to preoperative, for both groups (p < 0.001).

CONCLUSION

Percutaneous sono-guided release using Sono-Instruments® is safe and efficient, and associated with quick functional recovery.

LEVEL OF EVIDENCE

II.

摘要

目的

评估 Sono-Instruments®超声引导下经皮松解术治疗腕管综合征(CTS)和扳机指(TF)的安全性和有效性。

方法

前瞻性研究,纳入 30 例患者,分为两组(15 例 CTS,15 例 TF)。主要手术相关结局(Sono-Instruments®的可视性、易用性、满意度、操作时间)和患者相关结局(疼痛、活动受限、恢复工作时间、功能评分)。次要结局包括并发症。患者术后随访 2 个月。

结果

CTS 组患者平均年龄 58.7 岁。所有患者均成功完成腕横韧带的经皮松解,器械性能良好,无不良事件发生。术后 1 周,所有患者均能洗手,80%能进行日常生活活动,80%的患者已恢复工作。术后 2 个月,所有患者均恢复了所有活动。53.3%的患者仍存在柱间疼痛。TF 组患者平均年龄 57.9 岁。所有患者均成功完成 A1 环状滑车的经皮松解,器械性能良好,无不良事件发生。术后 1 周,所有患者均能洗手,93.3%能进行日常生活活动,75%的患者恢复了工作。术后 2 个月,所有患者均恢复了日常生活和工作。与术前相比,两组的 DASH 评分在术后 2 个月均显著改善(p<0.001)。

结论

Sono-Instruments®超声引导下经皮松解术安全有效,可快速恢复功能。

证据等级

II 级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c455/11496405/7b25b38132f3/40477_2023_851_Fig1_HTML.jpg

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