Document Detail

Percutaneous release, open surgery, or corticosteroid injection, which is the best treatment method for trigger digits?
MedLine Citation:
PMID:  23208122     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Percutaneous A1 pulley release surgery for trigger digit (finger or thumb) has gained popularity in recent decades. Although many studies have reported the failure rate and complications of percutaneous release for trigger digit, the best treatment for trigger digit remains unclear.
QUESTIONS/PURPOSES: Our aim was to identify the relative risk of treatment failure, level of satisfaction, and frequency of complications, comparing percutaneous release with open surgery or corticosteroid injections for adult patients with trigger digits.
METHODS: We searched PubMed, Embase, and the Cochrane Library for randomized controlled trials (RCTs), comparing percutaneous release with open surgery or corticosteroid injections. Seven RCTs involving 676 patients were identified. Methodologic quality was assessed by the Detsky quality scale. After data extraction, we compared results using a fixed meta-analysis model.
RESULTS: There were no differences in the failure rate (risk ratio [RR] = 0.93; 95% CI, 0.14-6.25) and complication frequency (RR = 0.83; 95% CI, 0.15-4.72) between patients undergoing percutaneous release and open surgery. Patients treated with percutaneous release had fewer failures (RR = 0.07; 95% CI, 0.02-0.21) and a greater level of satisfaction (RR = 2.01; 95% CI, 1.62-2.48) compared with the patients treated with corticosteroid injections. We found no difference in complication frequency between percutaneous release and corticosteroid injection (RR = 3.19; 95% CI, 0.51-19.91).
CONCLUSIONS: The frequencies of treatment failure and complications were no different between percutaneous release surgery and open surgery for trigger digit in adults. Patients treated with percutaneous releases were less likely to have treatment failure than patients treated with corticosteroid injections.
Jia Wang; Jia-Guo Zhao; Cong-Cong Liang
Publication Detail:
Type:  Comparative Study; Journal Article; Meta-Analysis     Date:  2012-12-04
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  471     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-02     Completed Date:  2013-06-25     Revised Date:  2014-06-03    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1879-86     Citation Subset:  AIM; IM    
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MeSH Terms
Glucocorticoids / therapeutic use*
Injections, Intra-Articular
Orthopedic Procedures / adverse effects,  methods*
Postoperative Complications
Randomized Controlled Trials as Topic
Surgical Procedures, Minimally Invasive / adverse effects,  methods*
Treatment Failure
Treatment Outcome
Trigger Finger Disorder / drug therapy*,  surgery*
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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