Abstract：
BACKGROUND: Trigger finger (also known as stenosing tenosynovitis) is a chronic inflammatory disorder that affects the fingers and causes discomfort and functional impairment. It is estimated to affect 2-3.6% of the population and is more common in manual laborers and individuals engaged in repetitive hand activities. This study comprehensively compares the efficacy of ultrasound-guided release versus traditional open surgery in treating trigger fingers.
METHODS: We systematically searched PubMed, Scopus, EMBASE, and the Cochrane Library to identify relevant studies. Inclusion criteria were studies evaluating ultrasound-guided release of trigger finger (grade 2 and higher) compared with open surgical release. A meta-analysis was performed by Revman software 5.4.1 to assess efficacy, utilizing appropriate statistical methods to address heterogeneity. Primary outcome measures included \"Quick Disability of Arm, Shoulder, and Hand\" (QDASH) scores, Grip strength, and the Visual Analogue Scale (VAS). Secondary outcome measures included Days of stopping analgesia, full-digit flexion and extension, days to return to normal activities, pinch strength, Quinnell grading score, and bow strengthening.
RESULTS: Out of the initial pool of 820 studies, five met the inclusion criteria, including 275 patients with 283 trigger digits. The analysis revealed significant differences favoring the ultrasound-guided release group over the surgical group for improvement in Quick Disability of Arm, Shoulder, and Hand score in the first month (MD -0.48, 95% CI: 0.75 to -0.2, P = .0007, I2 = 20%). The difference was not statistically significant in the 3-month follow-up period (MD -2.25, 95% CI: -0.54 to 0.05, P = .1, I2 = 0%). Additionally, there is a significant difference in the days required for return to normal activities in favor of the ultrasound release approach (MD -13.78, 95% CI: -16.68 to 10.89, P = .00001, I2 = 68%). The data displayed heterogeneity, which was resolved through sensitivity analysis that also favored the ultrasound-guided group. In terms of grip strength, full-digit flexion and extension, VAS, and days of stopping analgesia no significant differences were observed.
CONCLUSIONS: Ultrasound-guided release showed advantages over open surgical release, resulting in improved QDASH score and quicker return to normal activities. This offers a minimally invasive, successful alternative to open surgery, reducing associated risks. Further studies with long-term follow-up are recommended.
METHODS: We systematically searched PubMed, Scopus, EMBASE, and the Cochrane Library to identify relevant studies. Inclusion criteria were studies evaluating ultrasound-guided release of trigger finger (grade 2 and higher) compared with open surgical release. A meta-analysis was performed by Revman software 5.4.1 to assess efficacy, utilizing appropriate statistical methods to address heterogeneity. Primary outcome measures included \"Quick Disability of Arm, Shoulder, and Hand\" (QDASH) scores, Grip strength, and the Visual Analogue Scale (VAS). Secondary outcome measures included Days of stopping analgesia, full-digit flexion and extension, days to return to normal activities, pinch strength, Quinnell grading score, and bow strengthening.
RESULTS: Out of the initial pool of 820 studies, five met the inclusion criteria, including 275 patients with 283 trigger digits. The analysis revealed significant differences favoring the ultrasound-guided release group over the surgical group for improvement in Quick Disability of Arm, Shoulder, and Hand score in the first month (MD -0.48, 95% CI: 0.75 to -0.2, P = .0007, I2 = 20%). The difference was not statistically significant in the 3-month follow-up period (MD -2.25, 95% CI: -0.54 to 0.05, P = .1, I2 = 0%). Additionally, there is a significant difference in the days required for return to normal activities in favor of the ultrasound release approach (MD -13.78, 95% CI: -16.68 to 10.89, P = .00001, I2 = 68%). The data displayed heterogeneity, which was resolved through sensitivity analysis that also favored the ultrasound-guided group. In terms of grip strength, full-digit flexion and extension, VAS, and days of stopping analgesia no significant differences were observed.
CONCLUSIONS: Ultrasound-guided release showed advantages over open surgical release, resulting in improved QDASH score and quicker return to normal activities. This offers a minimally invasive, successful alternative to open surgery, reducing associated risks. Further studies with long-term follow-up are recommended.
摘要：
背景：触发手指（也称为狭窄性腱鞘炎）是一种慢性炎症性疾病，会影响手指并引起不适和功能障碍。据估计，它影响了2-3.6％的人口，在体力劳动者和从事重复性手部活动的个人中更为常见。这项研究全面比较了超声引导下松解术与传统开放手术治疗扳机指的疗效。
方法：我们系统地搜索了PubMed，Scopus,EMBASE,和Cochrane图书馆来确定相关研究。纳入标准是评估超声引导下的触发指释放（2级及更高）与开放手术释放相比的研究。通过Revman软件5.4.1进行荟萃分析以评估疗效，利用适当的统计方法来解决异质性。主要结局指标包括“手臂快速残疾，肩膀,和手牌（QDASH）得分，握力,和视觉模拟量表(VAS)。次要结果指标包括止痛天数，全数屈伸,恢复正常活动的天数，夹紧强度,Quinnell评分,和弓加强。
结果：在最初的820项研究中，五人符合入选标准，包括275名患者，有283个触发数字。分析显示，在改善手臂快速残疾方面，超声引导松解术组优于手术组。肩膀,和第一个月的手评分（MD-0.48，95％CI：0.75至-0.2，P=.0007，I2=20％）。3个月随访期间差异无统计学意义(MD-2.25,95%CI:-0.54~0.05,P=.1,I2=0%)。此外,与超声释放方法相比，恢复正常活动所需的天数存在显着差异（MD-13.78，95％CI：-16.68至10.89，P=.00001，I2=68％）。数据显示出异质性，通过敏感性分析解决了这一问题，该敏感性分析也有利于超声引导组。在握力方面，全数屈伸,VAS,和停止镇痛的天数没有观察到显著差异。
结论：超声引导下的松解术比开放手术松解术具有优势，从而提高QDASH评分和更快地恢复正常活动。这提供了一种微创，成功替代开放手术，降低相关风险。建议进行长期随访的进一步研究。
方法：我们系统地搜索了PubMed，Scopus,EMBASE,和Cochrane图书馆来确定相关研究。纳入标准是评估超声引导下的触发指释放（2级及更高）与开放手术释放相比的研究。通过Revman软件5.4.1进行荟萃分析以评估疗效，利用适当的统计方法来解决异质性。主要结局指标包括“手臂快速残疾，肩膀,和手牌（QDASH）得分，握力,和视觉模拟量表(VAS)。次要结果指标包括止痛天数，全数屈伸,恢复正常活动的天数，夹紧强度,Quinnell评分,和弓加强。
结果：在最初的820项研究中，五人符合入选标准，包括275名患者，有283个触发数字。分析显示，在改善手臂快速残疾方面，超声引导松解术组优于手术组。肩膀,和第一个月的手评分（MD-0.48，95％CI：0.75至-0.2，P=.0007，I2=20％）。3个月随访期间差异无统计学意义(MD-2.25,95%CI:-0.54~0.05,P=.1,I2=0%)。此外,与超声释放方法相比，恢复正常活动所需的天数存在显着差异（MD-13.78，95％CI：-16.68至10.89，P=.00001，I2=68％）。数据显示出异质性，通过敏感性分析解决了这一问题，该敏感性分析也有利于超声引导组。在握力方面，全数屈伸,VAS,和停止镇痛的天数没有观察到显著差异。
结论：超声引导下的松解术比开放手术松解术具有优势，从而提高QDASH评分和更快地恢复正常活动。这提供了一种微创，成功替代开放手术，降低相关风险。建议进行长期随访的进一步研究。
