AIMTo investigate the effectiveness of ultrasound-guided release of the first annular pulley and compare results with the conventional open operative technique.METHODSIn this prospective randomized, single-center, clinical study, 32 patients with trigger finger or trigger thumb, grade II-IV according to Green classification system, were recruited. Two groups were formed; Group A (16 patients) was treated with an ultrasound-guided percutaneous release of the affected A1 pulley under local anesthesia. Group B (16 patients) underwent an open surgical release of the A1 pulley, through a 10-15 mm incision. Patients were assessed pre- and postoperatively (follow-up: 2, 4 and 12 wk) by physicians blinded to the procedures. Treatment of triggering (primary variable of interest) was expressed as the “success rate” per digit. The time for taking postoperative pain killers, range of motion recovery, QuickDASH test scores (Greek version), return to normal activities (including work), complications and cosmetic results were assessed.RESULTSThe success rate in group A was 93.75% (15/16) and in group B 100% (16/16). Mean times in group A patients were 3.5 d for taking pain killers, 4.1 d for returning to normal activities, and 7.2 and 3.9 d for complete extension and flexion recovery, respectively. Mean QuickDASH scores in group A were 45.5 preoperatively and, 7.5, 0.5 and 0 after 2, 4, and 12 wk postoperatively. Mean times in group B patients were 2.9 d for taking pain killers, 17.8 d for returning to normal activities, and 5.6 and 3 d for complete extension and flexion recovery. Mean QuickDASH scores in group B were 43.2 preoperatively and, 8.2, 1.3 and 0 after 2, 4, and 12 wk postoperatively. The cosmetic results found excellent or good in 87.5% (14/16) of group A patients, while in 56.25% (9/16) of group B patients were evaluated as fair or poor.CONCLUSIONTreatment of the trigger finger using ultrasonography resulted in fewer absence of work days, and better cosmetic results, in comparison with the open surgery technique. It is a promising method that represents excellent results without major complications, so that it could be possibly be established as a first-line treatment in the trigger finger’s disease.

The purpose of this study is to demonstrate whether and to what extent a single injection of platelet-rich plasma (PRP), under ultrasound guidance, can improve the clinical symptoms of patients with a mild to moderate carpal tunnel syndrome (CTS). We conducted a prospective, randomized, clinical study including 50 patients suffering from mild to moderate CTS for a minimum duration of 3 months. Patients were randomly divided into 2 groups: Group A (26 patients) received an ultrasound-guided PRP injection into the carpal tunnel, whereas Group B (24 patients) was injected with placebo (0.9% normal saline). The short- and mid-term outcomes were determined with the use of the Q-DASH questionnaire and the pain scale VAS administered at 0, 4, and 12 weeks follow-up. The success ratio was determined by the difference in the Q-DASH obtained pre-injection minus the final Q-DASH obtained after 12 weeks follow-up. Success was defined as a difference more than 25%. Group A patients demonstrated a 76.9% success as determined by the difference Q-DASH, whereas Group B patients demonstrated 33.3% success, which was significantly less than Group A (Χ , p = .011). The findings of this study suggest that a single PRP ultrasound-guided injection has positive effects in patients with CTS.

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Background New types of glenoid bone block fixation, involving suture buttons, suture anchors or even implant-free impaction of the graft, have been recently introduced. In contrast to screws which allow for a rigid fixation of the bone block, these alternative procedures provide a non-rigid type of fixation. Methods Two reviewers independently conducted the search in a systematic way (according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) using the MEDLINE/PubMed database and the Cochrane Database of Systematic Reviews. These databases were queried with the terms “Latarjet” OR “Eden-Hybbinette” OR “bone block” AND “anterior” AND “shoulder” AND “instability.” Results Eight out of the 325 initial studies were finally chosen according to our inclusion–exclusion criteria. In total, 750 patients were included in this review. The overall anterior instability recurrence rate for patients treated with non-rigid fixation was 2.6%, while the overall rate of non-union or graft osteolysis was 5.4%. Conclusions Regardless of the graft type, bone block non-rigid fixation showed satisfactory clinical and functional outcomes for the treatment of anterior shoulder instability with substantial glenoid bone deficiency. Furthermore, non-rigid fixation resulted in adequate bone graft healing and osseous incorporation. Lastly, given the relative lack of data, further prospective controlled studies are required to assess bone block non-rigid fixation procedures in comparison with the traditional rigid (with screws) fixation techniques. Level Systematic review, IV.