title: Percutaneous first annular pulley release for trigger digits: a systematic review and meta-analysis of current evidence.
abstract: OBJECTIVE
  To determine the overall success rate and potential influencing factors within the current evidence for percutaneous first annular pulley release.
  
  
  METHODS
  We searched PubMed, EMBASE, and the Cochrane Library for all clinical studies of percutaneous release. The rates of successful procedure and complication were extracted and analyzed. We charted the overall success rate on a forest plot with 95% confidence intervals. Data of success rates were analyzed in 5- and 10-year intervals to determine whether the rate of success had increased chronologically. We then performed 3 subgroup analyses according to instrument type (needles vs knife blades), cortisone use (cortisone vs noncortisone), and sonography guidance (sonography vs non-sonography guidance). Pooled success rates were calculated in the subgroups and compared using chi-square test.
  
  
  RESULTS
  A total of 34 studies involving 2,114 percutaneous procedures were included in this systematic review and meta-analysis. The total success rate was 94%. There was a trend toward increasing number of publications in the past 20 years. We found a statistically significant trend showing that overall success rates had increased over time. Chi-square test revealed that percutaneous release with sonography guidance had a significantly higher success rate than non-sonography guidance. There were no significant differences in other subgroup analyses including instrument type and cortisone use.
  
  
  CONCLUSIONS
  Percutaneous release is an effective and safe procedure for the treatment of trigger digit. It has become progressively popular in recent years, with a trend toward increased overall success. Sonography might be a helpful tool for maximizing success. The success rates were not affected by instruments and cortisone use.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Departments of Orthopaedic Surgery, Hand Surgery, Sports Medicine and Arthroscopic Surgery, Orthopaedic Radiology, and Orthopaedic Traumatology, Tianjin Hospital, Clinical College of Orthopaedic Surgery, Tianjin Medical University, Tianjin, China. Electronic address: orthopaedic@163.com.
authors.forename: Jia-Guo
authors.initials: JG
authors.lastname: Zhao
authors.affiliation: Departments of Orthopaedic Surgery, Hand Surgery, Sports Medicine and Arthroscopic Surgery, Orthopaedic Radiology, and Orthopaedic Traumatology, Tianjin Hospital, Clinical College of Orthopaedic Surgery, Tianjin Medical University, Tianjin, China.
authors.forename: Shi-Lian
authors.initials: SL
authors.lastname: Kan
authors.affiliation: Departments of Orthopaedic Surgery, Hand Surgery, Sports Medicine and Arthroscopic Surgery, Orthopaedic Radiology, and Orthopaedic Traumatology, Tianjin Hospital, Clinical College of Orthopaedic Surgery, Tianjin Medical University, Tianjin, China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhao
authors.affiliation: Departments of Orthopaedic Surgery, Hand Surgery, Sports Medicine and Arthroscopic Surgery, Orthopaedic Radiology, and Orthopaedic Traumatology, Tianjin Hospital, Clinical College of Orthopaedic Surgery, Tianjin Medical University, Tianjin, China.
authors.forename: Zeng-Liang
authors.initials: ZL
authors.lastname: Wang
authors.affiliation: Departments of Orthopaedic Surgery, Hand Surgery, Sports Medicine and Arthroscopic Surgery, Orthopaedic Radiology, and Orthopaedic Traumatology, Tianjin Hospital, Clinical College of Orthopaedic Surgery, Tianjin Medical University, Tianjin, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Long
authors.affiliation: Departments of Orthopaedic Surgery, Hand Surgery, Sports Medicine and Arthroscopic Surgery, Orthopaedic Radiology, and Orthopaedic Traumatology, Tianjin Hospital, Clinical College of Orthopaedic Surgery, Tianjin Medical University, Tianjin, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Wang
authors.affiliation: Departments of Orthopaedic Surgery, Hand Surgery, Sports Medicine and Arthroscopic Surgery, Orthopaedic Radiology, and Orthopaedic Traumatology, Tianjin Hospital, Clinical College of Orthopaedic Surgery, Tianjin Medical University, Tianjin, China.
authors.forename: Cong-Cong
authors.initials: CC
authors.lastname: Liang
mesh_terms: D006801:Humans; D019637:Orthopedic Procedures / Q000379:methods; D052582:Trigger Finger Disorder / Q000601:surgery*; D018084:Ultrasonography, Interventional
keywords: Trigger digit; meta-analysis; percutaneous release; sonography guidance; success rate