Ultrasound-guided vs. non-guided trigger finger release: a systematic review and meta-analysis

• Published in: International orthopaedics Vol. 48; no. 9; pp. 2429 - 2437
• Main Authors: Garcia, Hélio Rubens Polido, Mund, Eduardo, Romeiro, Pedro
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-09-2024
• Subjects: Humans; Medicine; Medicine & Public Health; Original Paper; Orthopedics; Randomized Controlled Trials as Topic; Treatment Outcome; Trigger Finger Disorder - surgery; Ultrasonography, Interventional - methods; Ultrasound-guided percutaneous release; Systematic review; Trigger finger; Stenosing tenosynovitis; Meta-analysis
• ISSN: 0341-2695; 1432-5195; 1432-5195
• DOI: 10.1007/s00264-024-06243-z

Purpose
Trigger finger (TF) is a common hand condition that can be treated with surgery. We conducted a systematic review and meta-analysis to assess whether ultrasound-guided (US-guided) percutaneous surgery is superior to other conventional surgical methods.
Methods
We conducted a comprehensive search in Medline, Embase, and the Cochrane Library to identify relevant studies. We included randomized clinical trials (RCTs) and observational studies comparing US-guided TF release with blind percutaneous or open approaches. We combined Risk Ratios (RR) and Mean Differences (MD) with 95% Confidence Intervals (CI) across studies. Data processing and analysis were conducted using R software, version 4.3.1.
Results
Our analysis included eight RCTs and two observational studies with 555 patients. US-guided surgery significantly reduced postoperative DASH scores (MD -3.75 points; 95% CI = -7.48, -0.02;
p
 < 0.01), shortened time to resume activities (MD -11.52 days; 95% CI = -16.13, -6.91;
p
 < 0.01), hastened discontinuation of oral analgesics (MD -4.44 days; 95% CI = -8.01, -0.87;
p
 < 0.01), and improved patient satisfaction scores (RR 1.13; 95% CI = 1.04, 1.23;
p
 = 0.75). There were no significant differences in VAS scores, time to movement recovery, or surgical success rate.
Conclusion
Ultrasound-guided percutaneous release is a safe, effective, and superior alternative for treating TF compared to other methods, leading to improved DASH scores, quicker recovery, faster cessation of oral analgesics, and enhanced patient satisfaction.