Objectives

To determine the efficacy of extracorporeal shockwave therapy (ESWT) and to determine the ideal energy flux density of wide-focused ESWT in the treatment of trigger finger (TF).

Design

Double-blind randomized controlled trial.

Setting

A university hospital.

Participants

A total of 60 patients (N=60) with grade II TF according to the Quinnell classification were randomly and evenly allocated to 3 treatment groups.

Interventions

Three treatment groups included a high-energy ESWT (HS) group (energy flux density of 0.01 mJ/mm², 5.8 bar, 1500 impulses, once per week for 4wk), a low-energy ESWT (LS) group (energy flux density of 0.006 mJ/mm², 3 bar, 1500 impulses, once per week for 4wk), and a sham intervention group (sham group). All participants received 6 months of follow-up after intervention when only painkillers were allowed as concomitant treatment.

Main Outcome Measures

Clinical outcomes were followed at baseline and 1, 3, and 6 months after intervention, including pain score, frequency of triggering, severity of triggering, functional impact of triggering, and quick Disabilities of the Arm, Shoulder, and Hand questionnaire (qDASH).

Results

All groups showed significant improvements from baseline in all clinical parameters, except for functional impact of triggering, 6 months after the interventions. However, the HS group demonstrated a higher magnitude of improvement than the LS and sham groups. In addition, the HS group reported significantly lower pain (P=.01) and lower qDASH (P=.008) than the sham group 6 months after the interventions. No adverse effects were reported in the HS and LS groups within 6 months of follow-up.

Conclusions

Wide-focused ESWT is a safe and effective but dose-dependent alternative facilitating pain relief and functional improvement in the treatment of grade II TF according to the Quinnell classification.

中文翻译：

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体外冲击波治疗扳机指：一项随机对照研究

目标

确定体外冲击波疗法（ESWT）的疗效，并确定宽聚焦ESWT治疗扳机指（TF）的理想能量通量密度。

设计

双盲随机对照试验。

环境

大学医院。

参与者

根据 Quinnell 分类，共有 60 例（N=60）患有 II 级 TF 的患者被随机平均分配到 3 个治疗组。

干预措施

三个治疗组包括一个高能量 ESWT (HS) 组（能量通量密度为 0.01 mJ/mm ²，5.8 bar，1500 次脉冲，每周一次，持续 4 周），一个低能量 ESWT (LS) 组（能量通量密度0.006 mJ/mm ²，3 bar，1500 次脉冲，每周一次，持续 4 周）和一个假干预组（假组）。所有参与者在干预后接受了 6 个月的随访，当时只允许使用止痛药作为伴随治疗。

主要观察指标

在基线和干预后 1、3 和 6 个月跟踪临床结果，包括疼痛评分、触发频率、触发严重程度、触发的功能影响以及手臂、肩部和手部快速残疾问卷 (qDASH)。

结果

干预后 6 个月，除了触发的功能影响外，所有组的所有临床参数均较基线有显着改善。然而，HS 组表现出比 LS 组和假组更高的改善幅度。此外，在干预后 6 个月，HS 组报告的疼痛（ P= .01）和 qDASH（P= .008）显着低于假手术组。随访 6 个月内，HS 组和 LS 组均未报告不良反应。

结论

根据 Quinnell 分类，广泛聚焦 ESWT 是一种安全有效但剂量依赖性的替代方案，可促进 II 级 TF 治疗中的疼痛缓解和功能改善。