Estratégias de tratamento para a tenossinovite estenosante em adultos: uma revisão da literatura

Abstract

Stenosis of the fingers and thumb is usually known as a trigger finger, a common condition that affects the flexor tendons in the osteofibrous tunnel in the A1 pulley. This pathology is characterized by finger palpation pain, mobility restrictions and impact on the function of the affected limb. The objective of the present study was to synthesize and critically analyze information from the scientific literature on conservative interventions (corticosteroid injection, orthoses and sessions of Physical Therapy and Occupational Therapy) or not (percutaneous release and open surgery) in the treatment of stenosing tenosynovitis, presenting the main results and the interventions considered most relevant. A systematized search was carried out in the databases: Scielo, BVS, PEDro, LILACS and Pubmed between 2008 and 2017. The search was performed with the following descriptors, used together by the expression "E": dedo em gatilho, tenossinovite estenosante, fisioterapia, terapia ocupacional, injeções, liberação percutânea, cirurgia aberta, cinesioterapia e exercício, in Portuguese. The corresponding terms in English were linked by the descriptor "AND": "trigger finger", "stenosing tenosynovitis", "physiotherapy", "occupational therapy", "injections", "percutaneous release", "open surgery", "kinesiotherapy" and "Exercise". For the analysis of the methodological quality of the articles, the PEDro Scale was used. Of the 96 studies initially found, seven were selected, which were considered of good methodological quality. According to the time of onset of the condition, conservative and invasive interventions in the treatment of stenosing tenosynovitis are effective and have shown significant gains in the improvement of pain and in the triggering of trigger finger symptoms. However, it was not possible to indicate if one of the interventions stands out from the others. In addition, we found only one study that addressed the treatment using physical therapy