Abstract：
BACKGROUND: Joint denervation of the wrist, basal joint of the thumb, and the finger is an option for patients with chronic pain. Compared with other surgical treatment options, function is preserved and the rehabilitation time is limited. A systematic review and meta-analysis were performed for each joint to determine whether the choice of technique and choice of denervation of specific articular sensory branches lead to a different outcome.
METHODS: Embase, MEDLINE (OvidSP), Web of Science, Scopus, PubMed publisher, Cochrane, and Google Scholar database searches yielded 17 studies with reported outcome on denervation of the wrist, eight on the basal joint of the thumb, and five on finger joints.
RESULTS: Overall, the level of evidence was low; only two studies included a control group, and none was randomized. Meta-analysis for pain showed a 3.3 decrease in visual analogue scale score for wrist pain. No difference was found between techniques (total versus partial denervation), nor did different approaches influence outcome. The first carpometacarpal joint showed a decrease for visual analogue scale score for pain of 5.4. Patient satisfaction with the treatment result was 83 percent and 82 percent, respectively. Reported pain in finger joints decreased 96 percent in the metacarpophalangeal joints, 81 percent in the proximal interphalangeal joint, and 100 percent in the distal interphalangeal joint. The only reported case in the metacarpophalangeal joint of the thumb reported an increase of 37 percent.
CONCLUSIONS: Only denervation of the metacarpophalangeal joint of the thumb reported an increase in pain; however, this was a single patient. Wrist and first carpometacarpal joint and finger joint denervation have a high satisfaction rate and decrease the pain. There was no difference between techniques.
METHODS: Embase, MEDLINE (OvidSP), Web of Science, Scopus, PubMed publisher, Cochrane, and Google Scholar database searches yielded 17 studies with reported outcome on denervation of the wrist, eight on the basal joint of the thumb, and five on finger joints.
RESULTS: Overall, the level of evidence was low; only two studies included a control group, and none was randomized. Meta-analysis for pain showed a 3.3 decrease in visual analogue scale score for wrist pain. No difference was found between techniques (total versus partial denervation), nor did different approaches influence outcome. The first carpometacarpal joint showed a decrease for visual analogue scale score for pain of 5.4. Patient satisfaction with the treatment result was 83 percent and 82 percent, respectively. Reported pain in finger joints decreased 96 percent in the metacarpophalangeal joints, 81 percent in the proximal interphalangeal joint, and 100 percent in the distal interphalangeal joint. The only reported case in the metacarpophalangeal joint of the thumb reported an increase of 37 percent.
CONCLUSIONS: Only denervation of the metacarpophalangeal joint of the thumb reported an increase in pain; however, this was a single patient. Wrist and first carpometacarpal joint and finger joint denervation have a high satisfaction rate and decrease the pain. There was no difference between techniques.
摘要：
背景：手腕关节神经支配，拇指的基底关节，手指是慢性疼痛患者的选择。与其他手术治疗方案相比,功能得以保留，康复时间有限。对每个关节进行了系统回顾和荟萃分析，以确定特定关节感觉分支的技术选择和神经支配选择是否会导致不同的结果。
方法：Embase，MEDLINE(OvidSP),WebofScience,Scopus,PubMed出版商,科克伦,GoogleScholar数据库搜索产生了17项研究，报告了手腕神经支配的结果，拇指基底关节上有八个，手指关节上有五个。
结果：总体而言，证据水平较低；只有两项研究包括对照组，没有一个是随机的。疼痛的荟萃分析显示，腕关节疼痛的视觉模拟评分降低了3.3。技术(完全和部分去神经)之间没有差异，不同的方法也不影响结果。第一腕掌关节显示疼痛的视觉模拟评分降低5.4。患者对治疗结果的满意度分别为83%和82%,分别。报告的手指关节疼痛在掌指关节中减少了96％，81%的近端指间关节,100%位于远端指间关节。唯一报告的拇指掌指关节病例报告增加了37％。
结论：只有拇指掌指关节的神经支配显示疼痛增加；然而，这是一个病人。腕关节和第一腕掌关节和手指关节神经支配具有很高的满意度，并且可以减轻疼痛。技术之间没有区别。
方法：Embase，MEDLINE(OvidSP),WebofScience,Scopus,PubMed出版商,科克伦,GoogleScholar数据库搜索产生了17项研究，报告了手腕神经支配的结果，拇指基底关节上有八个，手指关节上有五个。
结果：总体而言，证据水平较低；只有两项研究包括对照组，没有一个是随机的。疼痛的荟萃分析显示，腕关节疼痛的视觉模拟评分降低了3.3。技术(完全和部分去神经)之间没有差异，不同的方法也不影响结果。第一腕掌关节显示疼痛的视觉模拟评分降低5.4。患者对治疗结果的满意度分别为83%和82%,分别。报告的手指关节疼痛在掌指关节中减少了96％，81%的近端指间关节,100%位于远端指间关节。唯一报告的拇指掌指关节病例报告增加了37％。
结论：只有拇指掌指关节的神经支配显示疼痛增加；然而，这是一个病人。腕关节和第一腕掌关节和手指关节神经支配具有很高的满意度，并且可以减轻疼痛。技术之间没有区别。
