Ultrasound‐Guided <scp>A1</scp> Pulley Release Versus Classic Open Surgery for Trigger Digit

Rodríguez-Maruri, Guillermo; Rojo-Manaute, José Manuel; Capa-Grasa, Alberto; Rodríguez, Francisco Chana; López, Eugenio Cerezo; Vaquero, Javier

doi:10.1002/jum.16139

Cited by 2 publications

(1 citation statement)

References 52 publications

(121 reference statements)

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“…To resolve the heterogeneity, we conducted a sensitivity analysis in multiple scenarios, excluding one study in each scenario. Heterogeneity was best resolved by excluding the study of Maruri 11 ( P = .13, I 2 = 57%). After removing Maruri et al from the meta‐analysis model, the overall mean difference is still in favor of the US‐guided approach than the open surgical approach (MD −14.88, 95% CI: −17.28 to −12.48, P = .00001, Figure 6).…”

Section: Resultsmentioning

confidence: 99%

Efficacy of Ultrasound‐Guided Tendon Release for Trigger Finger Compared With Open Surgery

Amro,

Kashbour,

Shaaban Abdelgalil

et al. 2024

J of Ultrasound Medicine

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BackgroundTrigger 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.MaterialsWe 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.ResultsOut 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.ConclusionsUltrasound‐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.

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Section: Resultsmentioning

confidence: 99%