Wang Hsien-Chung, Lin Gau-Tyan
Department of Orthopedic Surgery, Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2004 Nov;20(11):546-51. doi: 10.1016/S1607-551X(09)70256-6.
A retrospective trial of percutaneous release for 40 trigger thumbs in 33 children under different types of anesthesia (general versus local) at a mean age of 2.5 years was conducted between February 1989 and March 2003. Based on the tolerance of the child and parents, 20 children were processed using local anesthesia at our office and 13 children were given general anesthesia. We recommend special manipulation to ensure complete release of the A1 pulley when general anesthesia is necessary. Of the 26 trigger thumbs in the local anesthesia group, 23 were successfully released. Only one patient in the general anesthesia group had an unsatisfactory outcome. Percutaneous surgery achieved a 90% successful release rate for trigger thumb in children, without recurrence. There was no statistical difference in the release of trigger thumbs with these two anesthetic procedures (p = 0.66). Overall, 37 trigger thumbs achieved full extension and flexion without any residual deformity following percutaneous release. Our results suggest that percutaneous release for trigger thumb is satisfactory, no matter which method of anesthesia is used.
1989年2月至2003年3月期间，对33名平均年龄为2.5岁的儿童的40例扳机指进行了不同麻醉类型（全身麻醉与局部麻醉）下的经皮松解回顾性试验。根据儿童和家长的耐受情况，20名儿童在我们办公室接受局部麻醉进行治疗，13名儿童接受全身麻醉。我们建议在必要进行全身麻醉时采用特殊手法以确保A1滑车完全松解。在局部麻醉组的26例扳机指中，23例成功松解。全身麻醉组只有1例患者效果不理想。经皮手术治疗儿童扳机指的成功率达90%，且无复发。这两种麻醉方法在扳机指松解方面无统计学差异（p = 0.66）。总体而言，37例扳机指经皮松解后实现了完全屈伸，无任何残留畸形。我们的结果表明，无论采用哪种麻醉方法，扳机指的经皮松解效果均令人满意。
