Stefano Artiaco, Francesco Bosco, Alessandro Lusso, Luigi Luca Cioffi, Bruno Battiston, Alessandro Massè
{"title":"屈肌腱滑轮损伤:文献和当前治疗方案的系统回顾。","authors":"Stefano Artiaco, Francesco Bosco, Alessandro Lusso, Luigi Luca Cioffi, Bruno Battiston, Alessandro Massè","doi":"10.1055/s-0042-1749420","DOIUrl":null,"url":null,"abstract":"<p><p>Closed injuries of the finger flexor pulley system are rare among the general population, and most of them occur during rock climbing. During the last few decades, scientific interest on this topic has increased. We conducted a systematic review of the literature according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The research was limited from January 2000 to March 2022. PubMed and Scopus databases were investigated for full-text articles published in English, French, and Italian using the following MeSH terms: ([pulley rupture] OR [finger pulley lesion]) AND ([injur*] OR [ruptur*] OR [damage] OR [trauma*]). Initial screening results identified 461 studies, among which 172 were included after including additional records identified through other sources and excluding repeated studies. Finally, four clinical studies were included in the analysis. The methodological quality of the articles was evaluated through the methodological index for nonrandomized studies (MINORS) score. Our search identified four studies that enrolled a total of 189 patients, of whom 164 were male and 25 were female. We finally examined 154 patients with a total of 208 pulleys damaged. Except for the thumb, all fingers were involved. Depending on the type of flexor pulley injury, graded with Schöffl classification, 69 patients underwent a surgical procedure, whereas 85 patients were treated conservatively. Closed finger pulleys injury occurred in rock climbers and non - rock climbers. All patients had excellent results on the Buck-Gramcko score regardless of the return to sports activity. Considering the overall outcomes of the reviewed articles, functional results were satisfactory in both conservative and surgical treatment. Moreover, in grade 3 and 4, surgical results were positive regardless of the specific technique used for finger pulley reconstruction. Only minor complications were reported. Closed flexor tendon pulley injuries require a careful clinical and imaging examination to confirm the diagnosis. In most cases, positive clinical results can be achieved with either conservative or surgical therapy.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"15 4","pages":"247-252"},"PeriodicalIF":0.3000,"publicationDate":"2022-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10495204/pdf/10-1055-s-0042-1749420.pdf","citationCount":"0","resultStr":"{\"title\":\"Flexor Tendon Pulley Injuries: A Systematic Review of the Literature and Current Treatment Options.\",\"authors\":\"Stefano Artiaco, Francesco Bosco, Alessandro Lusso, Luigi Luca Cioffi, Bruno Battiston, Alessandro Massè\",\"doi\":\"10.1055/s-0042-1749420\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Closed injuries of the finger flexor pulley system are rare among the general population, and most of them occur during rock climbing. During the last few decades, scientific interest on this topic has increased. We conducted a systematic review of the literature according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The research was limited from January 2000 to March 2022. PubMed and Scopus databases were investigated for full-text articles published in English, French, and Italian using the following MeSH terms: ([pulley rupture] OR [finger pulley lesion]) AND ([injur*] OR [ruptur*] OR [damage] OR [trauma*]). Initial screening results identified 461 studies, among which 172 were included after including additional records identified through other sources and excluding repeated studies. Finally, four clinical studies were included in the analysis. The methodological quality of the articles was evaluated through the methodological index for nonrandomized studies (MINORS) score. Our search identified four studies that enrolled a total of 189 patients, of whom 164 were male and 25 were female. We finally examined 154 patients with a total of 208 pulleys damaged. Except for the thumb, all fingers were involved. Depending on the type of flexor pulley injury, graded with Schöffl classification, 69 patients underwent a surgical procedure, whereas 85 patients were treated conservatively. Closed finger pulleys injury occurred in rock climbers and non - rock climbers. All patients had excellent results on the Buck-Gramcko score regardless of the return to sports activity. Considering the overall outcomes of the reviewed articles, functional results were satisfactory in both conservative and surgical treatment. Moreover, in grade 3 and 4, surgical results were positive regardless of the specific technique used for finger pulley reconstruction. Only minor complications were reported. Closed flexor tendon pulley injuries require a careful clinical and imaging examination to confirm the diagnosis. In most cases, positive clinical results can be achieved with either conservative or surgical therapy.</p>\",\"PeriodicalId\":45368,\"journal\":{\"name\":\"Journal of Hand and Microsurgery\",\"volume\":\"15 4\",\"pages\":\"247-252\"},\"PeriodicalIF\":0.3000,\"publicationDate\":\"2022-06-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10495204/pdf/10-1055-s-0042-1749420.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hand and Microsurgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1055/s-0042-1749420\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/9/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hand and Microsurgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1055/s-0042-1749420","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/9/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
手指屈肌滑轮系统的闭合性损伤在普通人群中非常罕见,大多数损伤发生在攀岩过程中。在过去的几十年中,科学界对这一话题的兴趣与日俱增。我们根据系统综述和元分析首选报告项目(PRISMA)指南对文献进行了系统综述。研究时间限于 2000 年 1 月至 2022 年 3 月。研究人员在 PubMed 和 Scopus 数据库中使用以下 MeSH 词:([滑轮断裂] OR [手指滑轮病变])和([损伤*] OR [断裂*] OR [损伤] OR [创伤*])搜索以英语、法语和意大利语发表的全文文章。初步筛选结果确定了 461 项研究,其中 172 项研究包括了通过其他来源确定的其他记录,并排除了重复研究。最后,四项临床研究被纳入分析。文章的方法学质量通过非随机研究方法学指数(MINORS)评分进行评估。我们在搜索中发现了四项研究,共招募了 189 名患者,其中男性 164 名,女性 25 名。最终,我们对 154 名患者进行了检查,共发现 208 个滑轮受损。除拇指外,所有手指均受累。根据屈指滑轮损伤的类型(按舍弗尔分类法分级),69 名患者接受了手术治疗,85 名患者接受了保守治疗。攀岩运动员和非攀岩运动员都有手指滑轮闭合性损伤。无论是否恢复运动,所有患者的巴克-格拉姆科评分结果都非常好。从综述文章的总体结果来看,保守治疗和手术治疗的功能效果都令人满意。此外,在3级和4级患者中,无论采用哪种具体的指滑轮重建技术,手术效果都很好。仅有轻微并发症的报道。闭合性屈肌腱滑轮损伤需要通过仔细的临床和影像学检查来确诊。在大多数情况下,保守治疗或手术治疗都能取得良好的临床效果。
Flexor Tendon Pulley Injuries: A Systematic Review of the Literature and Current Treatment Options.
Closed injuries of the finger flexor pulley system are rare among the general population, and most of them occur during rock climbing. During the last few decades, scientific interest on this topic has increased. We conducted a systematic review of the literature according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The research was limited from January 2000 to March 2022. PubMed and Scopus databases were investigated for full-text articles published in English, French, and Italian using the following MeSH terms: ([pulley rupture] OR [finger pulley lesion]) AND ([injur*] OR [ruptur*] OR [damage] OR [trauma*]). Initial screening results identified 461 studies, among which 172 were included after including additional records identified through other sources and excluding repeated studies. Finally, four clinical studies were included in the analysis. The methodological quality of the articles was evaluated through the methodological index for nonrandomized studies (MINORS) score. Our search identified four studies that enrolled a total of 189 patients, of whom 164 were male and 25 were female. We finally examined 154 patients with a total of 208 pulleys damaged. Except for the thumb, all fingers were involved. Depending on the type of flexor pulley injury, graded with Schöffl classification, 69 patients underwent a surgical procedure, whereas 85 patients were treated conservatively. Closed finger pulleys injury occurred in rock climbers and non - rock climbers. All patients had excellent results on the Buck-Gramcko score regardless of the return to sports activity. Considering the overall outcomes of the reviewed articles, functional results were satisfactory in both conservative and surgical treatment. Moreover, in grade 3 and 4, surgical results were positive regardless of the specific technique used for finger pulley reconstruction. Only minor complications were reported. Closed flexor tendon pulley injuries require a careful clinical and imaging examination to confirm the diagnosis. In most cases, positive clinical results can be achieved with either conservative or surgical therapy.