Résumé
Background: Trigger finger is a common cause of disability and pain in the hand and The lines of management of this disease start by conservative treatment as rest, NSAID, local corticosteroid injection under the tendon sheath either blind or by musculoskeletal ultrasound guidance and surgery may indicated in recurrent cases
Aim of the study: The aim of the present study was to evaluate the musculoskeletal ultrasound accuracy to guide the injection of corticosteroid in trigger finger management
Material and methods: 50 cases that complaint from symptoms of trigger digit in this randomized, prospective control study were recorded. All the cases were injected by 1 ml corticosteroid 1ml of 2% lidocaine at the level of the A1 pulley under the tendon sheath. The injection done under control of musculoskeletal ultrasound after a blinded needle insertion. Comorbidities and associated diseases were recorded. Follow up examinations at the 2 week and 6 months, no complications were recorded. The results were assessed according to the green's grading. The pain was assessed according to visual analogue scale
Results: The cases in the present study were assessed according to age, associated diseases and hand dominance. The female patients were more than male patients in the present study. The injection under control of musculoskeletal ultrasound accurate more than a blinded injection even when an expert physician who did it. And It showed the same efficacy according to green's grading at the period of follow up examinations when compared with the pre-injection status. No complications were seen during the period of the follow up
Conclusion: A different technique of injection using musculoskeletal ultrasound guidance all of which gave excellent accuracy superior to a blinded injection even when it is done by expert physician. However, the post injection result was similar to that of a blinded injection. Level one of evidence [randomized prospective study]
Résumé
Background: trigger thumbs in children predominantly present with flexion deformity and a nodule at the MCP joint. Surgical release with a transverse incision and splitting of the A1 pulley achieves good cosmoses and attains a satisfactory range of motion with minimal complications
Aim of the Work: to analyze the results of treatment of congenital trigger thumb by open surgical release
Patients and Methods: this study was carried out on 12 patients with congenital trigger thumb treated by surgical release of A1 pulley after obtaining the hospital's Research Ethics Committee approval and written informed consents from the patients
Results: twelve patients were followed up for a mean of 10 [range 4-16] weeks, by which time they were all free of pain and had normal strength subjectively. Of the 12 patients evaluated postoperatively, all were able to fully extend the interphalangeal joint of the involved thumb
Conclusion: Surgical management is the most common treatment, and this is done effectively and safely in the hands of experienced surgeons with pediatric anesthesiologists