Comparison of efficacy and safety of USG-guided versus blind pulley release for trigger finger: A systematic review and meta-analysis
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Published on: May 26, 2023
Rachna Rohilla1, Harmeet Kaur2, Punit Tiwari3
1Department of Pharmacology, All India Institute of Medical Sciences, Bathinda, Punjab, India.
Background:
To compare the efficacy and safety of the USG-guided vs blind pulley release (PR) for Trigger Finger by performing a meta-analysis of all relevant studies in the published literature.
Methods:
A thorough and methodical search of the PubMed, Embase, Scopus, and Cochrane Library databases was carried out. Review Manager Software (RevMan) 5.4.1 was used to analyze the extracted data, and the results were displayed as forest plots with matching 95 % confidence intervals.
Results:
The primary efficacy outcome i.e. residual triggering was significantly lower in USG-guided PR as compared to blind PR with a risk ratio of 0.16 (95 % CI 0.03-0.87), p = 0.03. The primary safety outcome i.e., percentage of complications was lower in the USG-guided procedure group, although the result was not statistically significant with a risk ratio of 0.25 (95 % CI 0.05-1.16), p = 0.08 with I2 of 0 %. The operation time was longer in the USG-guided PR as compared to the blind procedure, although the difference was not statistically significant with a mean difference of 5.36 (95 % CI: -3.73, 14.46), p = 0.25. The postoperative visual analog scale (VAS) score at 4 weeks was significantly lower in USG-guided PR versus blind PR with a mean difference of -0.40 (95 % CI: -0.68, -0.33), p = 0.004.
Conclusion:
When compared to blind PR, ultrasound-guided A1 PR for trigger finger was proven to be a safer and more economical method.
