Cebesoy Oguz, Kose Kamil Cagri, Baltaci Enver Taner, Isik Mustafa
Orthopedic and Traumatology Department, Gaziantep University Faculty of Medicine, 27060 Gaziantep, Turkey.
Int Orthop. 2007 Jun;31(3):345-9. doi: 10.1007/s00264-006-0180-1. Epub 2006 Jul 18.
Percutaneous release of the trigger finger and trigger thumb has recently gained popularity. The aim of this study was to determine the clinical results and safety of percutaneous release in trigger thumbs. Twenty-five thumbs of 21 patients were released percutaneously in the polyclinic under local anaesthesia. Steroid injection was performed following the release procedure using the same needle. The thumb function was evaluated by a patient questionnaire, and functional thumb scores (VAS) were calculated in the preoperative and postoperative periods. At the 1 week follow-up, four patients had signs of discomfort and triggering because of incomplete release. These patients underwent open A1 pulley release. Three superficial tendon lacerations were seen during these open procedures. There were no wound complications or signs of digital nerve or artery injury in any of the patients. The preoperative mean VAS was 26.62 (18-36). This decreased to 2.57 (0-5) at the first postoperative month (P<0.001) and to 2.19 (0-3; P<0.001) at the sixth month. When the VAS scores at the first and sixth months were compared, the difference was statistically significant. We concluded that percutaneous release of trigger thumbs is a cheap, safe and effective procedure with a low rate of complications.
经皮扳机指和扳机拇指松解术近来颇受青睐。本研究旨在确定经皮扳机拇指松解术的临床效果及安全性。21例患者的25根拇指在门诊接受了局部麻醉下的经皮松解术。松解术后使用同一根针进行类固醇注射。通过患者问卷评估拇指功能，并计算术前和术后的拇指功能评分（视觉模拟评分法，VAS）。在1周随访时，4例患者因松解不完全出现不适和扳机现象。这些患者接受了开放性A1滑车松解术。在这些开放性手术过程中发现3例浅表肌腱撕裂伤。所有患者均未出现伤口并发症或指神经或动脉损伤迹象。术前平均VAS为26.62（18 - 36）。术后第1个月降至2.57（0 - 5）（P < 0.001），第6个月降至2.19（0 - 3；P < 0.001）。比较第1个月和第6个月的VAS评分，差异具有统计学意义。我们得出结论，经皮扳机拇指松解术是一种廉价、安全且有效的手术，并发症发生率低。
