The Journal of hand surgery, European volume
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J Hand Surg Eur Vol · Jan 2011
Randomized Controlled Trial Comparative StudyPercutaneous A1 pulley release vs steroid injection for trigger digit: the results of a prospective, randomized trial.
This study compared the results of percutaneous A1 pulley release and steroid injection in 105 trigger digits in 95 patients. The patients were randomly assigned to either surgery (43 patients, 46 digits) or steroid injection (52 patients, 59 digits). The results were assessed at 1 and 6 months and the measurements included rate of recurrence (primary outcome measure), pain on movement, active range of movement of the affected digit and grip strength. ⋯ At the 6 month assessment six recurrences (11%) occurred in the steroid injection group and none in the percutaneous release group (P = 0.005). Patients after percutaneous release had less pain on movement of the involved digit (VAS 0.4 vs 1.3), but still had lower AROM of the fingers (265° vs 270° after steroid injection). We conclude that percutaneous A1 pulley release is more effective medium-term therapy for trigger digit than steroid injection, because of lower risk of recurrence.
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J Hand Surg Eur Vol · Feb 2010
Randomized Controlled Trial Multicenter StudyEfficiency of Hyaloglide in the prevention of the recurrence of adhesions after tenolysis of flexor tendons in zone II: a randomized, controlled, multicentre clinical trial.
Hyaloglide is a hyaluronan-based gel based on a novel auto-crosslinked technology designed to reduce postsurgical adhesions. Its efficacy was assessed in a multicentred randomized controlled trial comparing the results of flexor tenolysis in zone 2 following failed flexor tendon repairs. In the control group a standard release was performed. ⋯ All the patients were evaluated at 30, 60, 90 and 180 days after surgery by testing Total Active Motion, Quick-DASH questionnaire and number of working days lost after surgery. Patients in the Hyaloglide group had a statistically better recovery of finger motion at all time intervals and returned earlier to work and daily activities. The use of Hyaloglide did not appear to increase the complication rate.
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J Hand Surg Eur Vol · Aug 2009
Randomized Controlled Trial Comparative StudyThe effect of miniscalpel-needle versus steroid injection for trigger thumb release.
This study compared the result of percutaneous release using a miniscalpel-needle and steroid injection in 93 trigger thumbs in 83 patients. The patients were randomly assigned to either miniscalpel-needle percutaneous release (group A) or steroid injection (group B). Visual analogue pain scales and patients' satisfaction were evaluated at baseline, 1 and 12 months. ⋯ Forty-four of the 46 trigger thumbs in group A and 12 of 47 trigger thumbs in group B had satisfactory results at 12 months. No digital nerve injury occurred in either group. Percutaneous release with a miniscalpel-needle had a higher success rate than steroid injection.
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J Hand Surg Eur Vol · Feb 2009
Randomized Controlled Trial Comparative StudySingle injection digital block: is a transthecal injection necessary?
Three different methods of injection to obtain digital block anaesthesia were performed on 15 healthy volunteers to evaluate the success and extent of anaesthesia. We found that the traditional transthecal injection technique was inaccurate and the injected agent mainly flowed into the subcutaneous space, and did not remain within the sheath. ⋯ However, the anaesthetic area after the deep transthecal injection was significantly smaller than that of the other two techniques (P<0.01). A transthecal digital block offers no advantage over a simple subcutaneous digital block.
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J Hand Surg Eur Vol · Aug 2008
Randomized Controlled TrialDigital blocks with and without adrenalin: a randomised-controlled study of capillary blood parameters.
This study compared fingertip capillary blood gas parameters before and after digital anaesthesia using lidocaine with and without Adrenalin. Twenty patients who underwent surgery on their fingers under digital ring block anaesthesia were randomly anaesthetised with 2% lidocaine or 2% lidocaine with 1:80,000 Adrenalin. Capillary blood parameters were measured prior to the digital blocks and 15 minutes after the injections. ⋯ However, this decrease was not statistically significant. Patients in the plain lidocaine group had return of sensation to the finger tip 4.8 (+/-0.6) hours after the operation. This period was 8.1 (+/-0.8) hours for the lidocaine with Adrenalin group.