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Stenosing tenosynovitis

Evaluation of percutaneous release with a specially designed needle vs. open surgery

Stenosierende Tenosynovitis

Evaluation der perkutanen Ringbandspaltung mit einer speziell entwickelten Nadel vs. offene Operation

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Abstract

Purpose

The purpose of this study was to evaluate the effectiveness of conventional open surgery and percutaneous release with a specially designed needle for treating stenosing tenosynovitis in terms of cure, relapse and complication rates.

Methods

In this study 89 fingers from 76 patients were randomly assigned and allocated to one of the treatment groups. A total of 37 patients were treated with open surgery in group 1 and 39 patients with percutaneous release using a specially designed needle in group 2. A patient-based 4-inch visual analogue scale (VAS), Quinnell grading (QG), disability of arm shoulder and hand (DASH) score and finger total joint range of motion (FTROM) score were evaluated before treatment and after 7, 30 and 180 days. When finger QG scores were equal or greater than 2 points at follow-up at 180 days this was defined as recurrence..

Results

There were no significant differences between the two groups (P > 0.05) in terms of VAS, DASH and QG scores and the degree of FTROM. At 7 days all the data were significantly different (p < 0.05) compared with preoperative data, 30 days was significantly different (p < 0.05) compared with 7 days while at 180 days no significant differences could be found (p > 0.05) compared with 30 days. The recurrence rate in group 1 was 4.65% and 6.55% in group 2.

Conclusion

The percutaneous release and open surgery methods displayed similar effectiveness regarding the cure and recurrence of trigger finger disorder. The use of a specially designed needle for release is a safe and reliable method.

Zusammenfassung

Zweck

Der Zweck dieser Studie war es, die Wirksamkeit der konventionellen offenen Operation und der perkutanen Ringbandspaltung mit einer speziell entwickelten Nadel zur Behandlung einer stenosierenden Tenosynovitis bezüglich Heilung, Rezidiv und Komplikationsraten zu evaluieren.

Methoden

In dieser Studie wurden 89 Finger von 76 Patienten randomisiert zugeordnet und einer der Behandlungsgruppen zugeteilt. Insgesamt 37 Patienten erhielten eine offene Operation in Gruppe 1 und 39 Patienten eine perkutane Ringbandspaltung mittels einer speziell entwickelten Nadel in Gruppe 2. Eine patientenbasierte 10 cm visuelle Analogskala (VAS), die Klassifizierung nach Quinnell (QG), der Disability-of-Arm-Shoulder-and-Hand(DASH)-Score und der Finger-Total-Joint-Range-of-Motion(FTROM)-Score wurden vor sowie 7, 30 und 180 Tage nach der Behandlung untersucht. Betrug der Finger-QG-Score beim Follow-up 2 oder mehr Punkte, wurde dies als Rezidiv definiert.

Ergebnisse

Es gab keine signifikanten Unterschiede zwischen den beiden Gruppen (p > 0,05) bezüglich der VAS-, DASH- und QG-Scores sowie hinsichtlich des Grades der FTROM. Nach 7 Tagen zeigte sich ein signifikanter Unterschied bei allen Werten (p < 0,05), nach 30 Tagen war der Unterschied signifikant (p < 0,05) im Vergleich zu 7 Tagen, während nach 180 Tagen kein signifikanter Unterschied festgestellt werden konnte (p < 0,05). Die Rezidivrate in Gruppe 1 betrug 4,65% und 6,55% in Gruppe 2.

Schlussfolgerung

Die perkutane Ringbandspaltung und die offenen Operationsverfahren zeigten eine ähnliche Wirksamkeit bezüglich der Heilung und des Auftretens eines Rezidivs bei der Behandlung eines schnellenden Fingers. Die Verwendung einer speziell entwickelten Nadel für die Spaltung stellt eine sichere und verlässliche Methode dar.

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Abbreviations

DASH:

Disability of the arm, shoulder and hand

FTROM:

Finger total joint range of motion

QG:

Quinnell grading

RA:

Rheumatoid arthritis

VAS:

Visual analogue scale

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Acknowledgements

The authors would like to thank the students and staffs who participated in discussion as well as help and comments on this study.

Author contributions

Xue-dong Li and Shi-xin Du are corresponding author and organized the study. Gui-zhou Zheng and Peng Xie analyzed the data. Qi-hao Zhang, Wei-fang Zhang, Hou-guang Miao and Jian-feng Ye performed experiments. Qi-hao Zhang, De-zhong Liu and Hou-guang Miao drafted the manuscript. All authors read and approved the final manuscript.

Funding

The study was supported by Science and technology Research and Development Foundation of Shenzhen (JCYJ20160429172357751).

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Authors and Affiliations

  1. Department of Orthopedics, The Third Affiliated Hospital (The Affiliated Luohu Hospital) of Shenzhen University, 518000, Shenzhen, Guangdong, China

    Peng Xie, Qi-hao Zhang, Gui-zhou Zheng, Hou-guang Miao, Wei-fang Zhang, Jian-feng Ye, Shi-xin Du & Xue-dong Li

  2. Department of Emergency, First Affiliated Hospital, Shantou University Medical College, 515041, Shantou, Guangdong, China

    De-zhong Liu

Authors
  1. Peng Xie
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Corresponding authors

Correspondence to Shi-xin Du or Xue-dong Li.

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Conflict of interest

P. Xie, Q.-h. Zhang, G.-z. Zheng, D.-z. Liu, H.-g. Miao, W.-f. Zhang, J.-f. Ye, S.-x. Du and X.-d. Li declare that they have no competing interests.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. All subjects provided written informed consent in accordance with institutional policies.

Additional information

Peng Xie, Qi-hao Zhang und Gui-zhou Zheng contributed equally to the manuscript.

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Xie, P., Zhang, Qh., Zheng, Gz. et al. Stenosing tenosynovitis. Orthopäde 48, 202–206 (2019). https://doi.org/10.1007/s00132-018-03676-4

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  • DOI: https://doi.org/10.1007/s00132-018-03676-4

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