Comparison of therapeutic effect of different types of acupotomies combined with compound betamethasone injection in the treatment of trigger finger under ultrasound guidance
LI Chunye, ZHANG Qian, WANG Hua, XIE Rong, ZHANG Xiaoyu
(Department of Pain Clinic, Affiliated Hospital of Jiangsu University, Zhenjiang Jiangsu 212001, China)
Abstract:Objective: To observe the clinical efficacy and safety of different types of needle knife combined with compound betamethasone injection under ultrasound guidance in the treatment of trigger finger. Methods: A total of 111 patients diagnosed with trigger finger in the Department of Pain Clinic Affiliated Hospital of Jiangsu University from May 2020 to May 2023 were selected as the study objects. The patients were randomly divided into three groups: group Ⅰ (n=36), group Ⅱ(n=37) and group Ⅲ (n=38). Group Ⅰ: ultrasound guidance + compound betamethasone injection alone group, group Ⅱ: ultrasound guidance + compound betamethasone injection + flat mouth needle knife group, group Ⅲ: ultrasound guidance + compound betamethasone injection + V-type needle knife group, the followup period was 6 months. The visual analogue score (VAS), modified Quinnell grade were recorded before treatment (T1), the next day after treatment (T2), 3 weeks after treatment (T3) and 6 months after treatment (T4),as well as the patient global impression of improvement (PGII) and recurrence rate at 6 months of treatment, operation time, adverse reactions were recorded. Results: ① Comparison of VAS score: At T2 time point, the score of group Ⅱ and group Ⅲ was significantly higher than that of group Ⅰ (P<0.001). The score of group Ⅱ was significantly higher than that of group Ⅲ (P<0.05). At T3 and T4 time points, the scores in group Ⅱ and group Ⅲ were significantly lower than those in group Ⅰ (P<0.05 and P<0.001). There was no significant difference between group Ⅱ and group Ⅲ (P>0.05). ② Comparison of improved Quinnell grading: At T2, T3 and T4 time points, the grade in group Ⅱ and group Ⅲ was significantly lower than that in group Ⅰ (P <0.05 and P<0.001). There was no significant difference in grade between group Ⅱ and group Ⅲ (P>0.05). ③ Comparison of PGII overall improvement scores: The scores of group Ⅱ and group Ⅲ were significantly higher than those of group Ⅰ (P<0.001). There was no significant difference between group Ⅱ and group Ⅲ (P>0.05). ④ Comparison of recurrence rate: It was significantly lower in group Ⅱ and group Ⅲ than that in group Ⅰ (P<0.05), but there was no significant difference between group Ⅱ and group Ⅲ (P>0.05). ⑤ Comparison of operating time: The time of group Ⅱ and group Ⅲ was significantly longer than that of group Ⅰ (P<0.001), and group Ⅱ was significantly longer than group Ⅲ (P<0.05). ⑥ There were no obvious adverse reactions in the three groups. Conclusion: The therapeutic effect of ultrasound-guided needle knife combined with compound betamethasone injection on trigger finger is better than that of compound betamethasone injection alone, and the release effect of V-type needle knife is better than that of flat-mouth needle knife.
[Key words]trigger finger; ultrasonic guidance; general type needle knife; V-shaped needle knife; acupotomy