Outcomes of percutaneous ultrasound-guided A1 pulley fenestration release with small-gauge needles for treatment of trigger finger.

IF 2.2 3区 医学 Q2 ORTHOPEDICS
Faysal F Altahawi, Gregory Owendoff, Eugen Lungu, Michael Forney
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引用次数: 0

Abstract

Objective: To retrospectively evaluate outcomes of an ultrasound-guided A1 pulley fenestration release technique using small-gauge (hypodermic or spinal) needles for the treatment of trigger finger (TF).

Materials and methods: A retrospective chart review of all TF fenestration release procedures performed by two musculoskeletal radiologists between July 2020 and August 2024 was conducted. The technique included a steroid injection after release. Preprocedural and postprocedural functional Quinnell grades and any immediate complications from the procedure report were primary outcome measures. Clinical pain score, functional outcomes, other TF interventions, and delayed complications were secondary outcome measures.

Results: A total of 119 procedures were performed in 92 patients (61% women, mean age 63 ± 13 years), with 95 procedures (80%) following prior TF injection with refractory symptoms. Periprocedural Quinnell grades were reported in 99 procedures (83%), with immediately improved scores for all (median-preprocedural-to-postprocedural, 3-to-0; p < 0.001). Retrospective follow-up data were available for 60 procedures (50%), of which 70% experienced functional improvement. Pain scores were significantly improved at follow-up (median-preprocedural-to-follow-up, 4-to-0.5; p = 0.046). Subsequent interventions occurred following 22 cases (18%), of which 15 (13%) required additional steroid injections, 3 (3%) required repeat fenestration, and 5 (4%) required surgical release. No immediate or delayed complications were otherwise reported. Higher Quinnell grade at end of procedure predicted increased rates of follow-up (OR = 3.17, p = 0.012) and suggested worse functional status at follow-up (OR = 0.25, p = 0.054), and smaller peri-procedural improvement increased odds of additional intervention (OR = 0.48, p < 0.001).

Conclusion: Ultrasound-guided fenestration is an effective and safe treatment for TF in the outpatient setting.

超声引导下小径针A1滑轮开窗松解术治疗扳机指的疗效。
目的:回顾性评价超声引导下小直径(皮下或脊髓)针A1滑轮开窗释放技术治疗扳机指(TF)的疗效。材料和方法:对2020年7月至2024年8月期间由两名肌肉骨骼放射科医生进行的所有TF开窗释放手术进行回顾性图表回顾。该技术包括释放后类固醇注射。手术前和手术后的功能Quinnell分级以及手术报告中的任何直接并发症是主要的预后指标。临床疼痛评分、功能结局、其他TF干预措施和延迟并发症是次要指标。结果:92例患者(61%为女性,平均年龄63±13岁)共行119例手术,其中95例(80%)既往注射TF后出现难治性症状。99例(83%)手术中报告了围术期Quinnell评分,所有手术的评分均立即提高(中位术前至术后,3至0;p)。结论:超声引导下开窗是门诊治疗TF的一种有效且安全的治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Skeletal Radiology
Skeletal Radiology 医学-核医学
CiteScore
4.40
自引率
9.50%
发文量
253
审稿时长
3-8 weeks
期刊介绍: Skeletal Radiology provides a forum for the dissemination of current knowledge and information dealing with disorders of the musculoskeletal system including the spine. While emphasizing the radiological aspects of the many varied skeletal abnormalities, the journal also adopts an interdisciplinary approach, reflecting the membership of the International Skeletal Society. Thus, the anatomical, pathological, physiological, clinical, metabolic and epidemiological aspects of the many entities affecting the skeleton receive appropriate consideration. This is the Journal of the International Skeletal Society and the Official Journal of the Society of Skeletal Radiology and the Australasian Musculoskelelal Imaging Group.
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