Efficacy analysis of three kinds of surgery for trigger thumb,International Orthopaedics

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Efficacy analysis of three kinds of surgery for trigger thumb
International Orthopaedics ( IF 2.0 ) Pub Date : 2022-09-10 , DOI: 10.1007/s00264-022-05573-0
Bin Wang _{1,

2} , Renjing Qi _{1,

2} , Jiaxiang Gu _{1,

2,

3} , Junyan Ye _{1,

2,

3} , Tianliang Wang _{1,

2} , Hongjun Liu _{1,

2} , Naichen Zhang _{1,

2} , Yiming Lu _{1,

2}

Affiliation

Purpose

To study the efficacy of three kinds of surgery for trigger thumb.

Methods

A total of 60 cases of trigger thumb (Quinnell Grade IV) were randomly divided into three groups. The A1 pulley was disconnected at the middle in Group A, at the extreme radial side in Group B, excised in Group C. The following indicators were recorded pre-operatively (D0), and at one (D1), three (D3), seven (D7), 14 (D14), and 28 (D28) days post-operatively: 1. the pain visual analogue score (VAS) when flexing the affected thumb; 2. range of motion (ROM) of the interphalangeal joint with pain tolerance; 3. the time of pain disappearance when flexing the affected thumb.

Results

The differences of VAS and ROM between D1 and D0, D3 and D1, D7 and D3, D14 and D7, D28 and D14 were statistically significant (P < 0.05). There was no significant difference in changes of VAS (or ROM) at D1 or D28 in contrast to D0 among the three groups. The differences of VAS (or ROM) changes at D3, D7, and D14 in contrast to D0 among the three groups were statistically significant (P < 0.05). The difference of the time when the pain disappearing in the normal range of motion among the three groups were statistically significant (P < 0.05).

Conclusion

Disconnecting the A1-pulley at the extreme radial side is better than another two methods for treating the trigger thumb (Quinnell Grade IV). It has been shown to effectively accelerate postoperative pain relief and functional recovery.

Trial registration

Clinical trial registry number: ChiCTR2100051193.

中文翻译：

扳机拇指三种手术方式的疗效分析

目的

研究三种手术治疗扳机拇指的疗效。

方法

60例扳机拇指（Quinnell IV级）随机分为三组。A组A1滑轮中部断开，B组最远桡侧，C组切除。术前记录以下指标（D0），1处（D1），3处（D3），术后 7 (D7)、14 (D14) 和 28 (D28) 天： 1. 弯曲受影响拇指时的疼痛视觉模拟评分 (VAS)；2. 具有疼痛耐受性的指间关节活动度（ROM）；3.屈曲患拇指疼痛消失时间。

结果

D1与D0、D3与D1、D7与D3、D14与D7、D28与D14的VAS及ROM比较差异均有统计学意义（P < 0.05）。与 D0 相比，三组之间 D1 或 D28 的 VAS（或 ROM）变化无显着差异。D3、D7、D14 时与 D0 相比，三组间 VAS（或 ROM）变化差异有统计学意义（P < 0.05）。三组患者在正常活动范围内疼痛消失时间比较差异有统计学意义（P < 0.05）。