Comparison of Efficacy and Safety of USG-guided Versus Blind Pulley Release for Trigger Finger: A Systematic Review and Meta-analysis

Overview

Journal J Clin Orthop Trauma

Specialty Orthopedics

Date 2024 Nov 18

PMID 39554281

Authors

Rachna Rohilla

Harmeet Kaur

Punit Tiwari

Affiliations

Soon will be listed here.

Abstract

Background: To compare the efficacy and safety of the USG-guided vs blind pulley release (PR) for Trigger Finger by performing a meta-analysis of all relevant studies in the published literature.

Methods: A thorough and methodical search of the PubMed, Embase, Scopus, and Cochrane Library databases was carried out. Review Manager Software (RevMan) 5.4.1 was used to analyze the extracted data, and the results were displayed as forest plots with matching 95 % confidence intervals.

Results: The primary efficacy outcome i.e. residual triggering was significantly lower in USG-guided PR as compared to blind PR with a risk ratio of 0.16 (95 % CI 0.03-0.87), p = 0.03. The primary safety outcome i.e., percentage of complications was lower in the USG-guided procedure group, although the result was not statistically significant with a risk ratio of 0.25 (95 % CI 0.05-1.16), p = 0.08 with I of 0 %. The operation time was longer in the USG-guided PR as compared to the blind procedure, although the difference was not statistically significant with a mean difference of 5.36 (95 % CI: -3.73, 14.46), p = 0.25. The postoperative visual analog scale (VAS) score at 4 weeks was significantly lower in USG-guided PR versus blind PR with a mean difference of -0.40 (95 % CI: -0.68, -0.33), p = 0.004.

Conclusion: When compared to blind PR, ultrasound-guided A1 PR for trigger finger was proven to be a safer and more economical method.

References

Lee S, Choi Y, Kang H . Comparative study of ultrasonography-guided percutaneous A1 pulley release versus blinded percutaneous A1 pulley release. J Orthop Surg (Hong Kong). 2018; 26(2):2309499018772368. DOI: 10.1177/2309499018772368. View

Lapegue F, Andre A, Meyrignac O, Pasquier-Bernachot E, Dupre P, Brun C . US-guided Percutaneous Release of the Trigger Finger by Using a 21-gauge Needle: A Prospective Study of 60 Cases. Radiology. 2016; 280(2):493-9. DOI: 10.1148/radiol.2016151886. View

Zhao J, Kan S, Zhao L, Wang Z, Long L, Wang J . Percutaneous first annular pulley release for trigger digits: a systematic review and meta-analysis of current evidence. J Hand Surg Am. 2014; 39(11):2192-202. DOI: 10.1016/j.jhsa.2014.07.044. View

Rojo-Manaute J, Rodriguez-Maruri G, Capa-Grasa A, Chana-Rodriguez F, Soto M, Vaquero Martin J . Sonographically guided intrasheath percutaneous release of the first annular pulley for trigger digits, part 1: clinical efficacy and safety. J Ultrasound Med. 2012; 31(3):417-24. DOI: 10.7863/jum.2012.31.3.417. View

Langer D, Maeir A, Michailevich M, Applebaum Y, Luria S . Using the international classification of functioning to examine the impact of trigger finger. Disabil Rehabil. 2016; 38(26):2530-7. DOI: 10.3109/09638288.2015.1137980. View

Burman M . Stenosing tendovaginitis of the dorsal and volar compartments of the wrist. AMA Arch Surg. 1952; 65(5):752-62. DOI: 10.1001/archsurg.1952.01260020744013. View

Sreedharan S, Teoh L, Chew W . Neuroma of the radial digital nerve of the middle finger following trigger release. Hand Surg. 2011; 16(1):95-7. DOI: 10.1142/S021881041100514X. View

Lunsford D, Valdes K, Hengy S . Conservative management of trigger finger: A systematic review. J Hand Ther. 2018; 32(2):212-221. DOI: 10.1016/j.jht.2017.10.016. View

Moore J . Flexor tendon entrapment of the digits (trigger finger and trigger thumb). J Occup Environ Med. 2000; 42(5):526-45. DOI: 10.1097/00043764-200005000-00012. View

10.

Fiorini H, Tamaoki M, Lenza M, Santos J, Faloppa F, Belloti J . Surgery for trigger finger. Cochrane Database Syst Rev. 2018; 2:CD009860. PMC: 6491286. DOI: 10.1002/14651858.CD009860.pub2. View

11.

Schubert C, Hui-Chou H, See A, Deune E . Corticosteroid injection therapy for trigger finger or thumb: a retrospective review of 577 digits. Hand (N Y). 2014; 8(4):439-44. PMC: 3840755. DOI: 10.1007/s11552-013-9541-6. View

12.

Lan X, Xiao L, Chen B, Xiong Y, Zou L, Luo J . A Comparison of the Outcomes of Open Trigger Release versus Ultrasound-Guided Modified Small Needle-Knife Percutaneous Release for Treatment of Trigger Digits. J Hand Surg Asian Pac Vol. 2023; 28(1):69-74. DOI: 10.1142/S2424835523500017. View

13.

Abe Y . Clinical results of a percutaneous technique for trigger digit release using a 25-gauge hypodermic needle with corticosteroid infiltration. J Plast Reconstr Aesthet Surg. 2016; 69(2):270-7. DOI: 10.1016/j.bjps.2015.10.006. View

14.

Nikolaou V, Malahias M, Kaseta M, Sourlas I, Babis G . Comparative clinical study of ultrasound-guided A1 pulley release open surgical intervention in the treatment of trigger finger. World J Orthop. 2017; 8(2):163-169. PMC: 5314146. DOI: 10.5312/wjo.v8.i2.163. View

15.

Rajeswaran G, Lee J, Eckersley R, Katsarma E, Healy J . Ultrasound-guided percutaneous release of the annular pulley in trigger digit. Eur Radiol. 2009; 19(9):2232-7. DOI: 10.1007/s00330-009-1397-3. View

16.

Quinnell R . Conservative management of trigger finger. Practitioner. 1980; 224(1340):187-90. View

17.

Chopin C, Le Guillou A, Salmon J, Lellouche H, Richette P, Maillet J . Treatment of Trigger finger by ultrasound-guided needle release of a1 pulley: A series of 105 cases. Joint Bone Spine. 2022; 89(6):105433. DOI: 10.1016/j.jbspin.2022.105433. View

18.

Pan M, Sheng S, Fan Z, Lu H, Yang H, Yan F . Ultrasound-Guided Percutaneous Release of A1 Pulley by Using a Needle Knife: A Prospective Study of 41 Cases. Front Pharmacol. 2019; 10:267. PMC: 6444079. DOI: 10.3389/fphar.2019.00267. View

19.

Makkouk A, Oetgen M, Swigart C, Dodds S . Trigger finger: etiology, evaluation, and treatment. Curr Rev Musculoskelet Med. 2009; 1(2):92-6. PMC: 2684207. DOI: 10.1007/s12178-007-9012-1. View

20.

Yildirim P, Gultekin A, Yildirim A, Karahan A, Tok F . Extracorporeal shock wave therapy versus corticosteroid injection in the treatment of trigger finger: a randomized controlled study. J Hand Surg Eur Vol. 2016; 41(9):977-983. DOI: 10.1177/1753193415622733. View