Nonoperative Treatment of Finger Flexor Tenosynovitis in Sport Climbers—A Retrospective Descriptive Study Based on a Clinical 10-Year Database

Abstract

The aim of this study was to describe the nonoperative treatment outcomes of finger flexor tenosynovitis in sport climbers and to evaluate the association with baseline measures and therapy contents. Sixty-five sport climbers (49 males, mean age 34.1 years) diagnosed with tenosynovitis of the finger flexors were retrospectively asked about injury triggers, therapy contents and outcomes. Pulley thickness was measured by ultrasound. All patients were initially treated conservatively, and only one of the patients needed further therapy (single injection with hyaluronic acid); none of them underwent surgical treatment. The most frequently applied therapy was climbing-related load reduction (91%). The treatment resulted in a statistically significant reduction in pain intensity during climbing (before/after therapy ratio [Visual Analog Scale (VAS)/VAS] = 0.62, 95% CI = 0.55, 0.68). The average duration of the symptoms was 30.5 weeks (range 1–120 weeks). In a multiple linear regression analysis, initial daily life pain intensity and a climbing level higher than 7b according to the French/sport grading scale were the only predictive parameters for the relative change in pain intensity and symptom duration, respectively. All patients were able to resume climbing, with 75% regaining or even exceeding their initial climbing level. The good to excellent outcomes and no correlation between particular therapy contents and therapy outcome may suggest that finger flexor tenosynovitis in sport climbers has a favorable natural course without requiring invasive therapy. However, further cohort studies and, ultimately, randomized controlled trials are needed to conclusively confirm our promising observations.

Revisão sistemática: uso de exames de imagem no auxílio diagnóstico de Tenossinovite Infecciosa

“…No relato de Nakamuara et al (17) , a US mostrou identificou ruptura do tendão FLP esquerdo. Na pesquisa de Mohn et al (6) foi realizado um exame ultrassonográfico das polias, bainhas dos tendões e tendões em um plano transversal, que identificou que a lesão ocorreu exclusivamente no dedo médio ou anular (58,5% e 55,4%, respectivamente), exceto em um caso em que o quinto dedo foi acometido.…”

“…A US é o exame de imagem mais conveniente para a infecção da mão. É prontamente disponível, em tempo real e de fácil obtenção, inofensivo e de baixo custo, sem necessidade de sedação em crianças (6) . Além disso, pode ajudar a diferenciar uma infecção profunda do tipo tenossinovite flexora piogênica ou infecção disseminada hematogênica de um local distante (7) .…”