Li Zhongyu, Wiesler Ethan R, Smith Beth P, Koman L Andrew
Department of Orthopaedic Surgery, Wake Forest University Baptist Medical Center, Medical Center Blvd, Winston-Salem, NC 27157 USA.
Hand (N Y). 2009 Dec;4(4):380-4. doi: 10.1007/s11552-009-9221-8. Epub 2009 Sep 1.
Between 1994 and 2004, seven patients (nine thumbs) at our institution were treated for trigger thumb with hyperextensible metacarpophalangeal (MP; >60°) anomaly with surgical release of the A1 pulley and proximal advancement of the MP volar plate. There were four girls and three boys (three right, two left, and two bilateral thumbs) with a mean age at surgery of 46 months (range, 26 to 82 months). The mean follow-up was 64 months (range, 1 to 8 years). At the time of the last follow-up, all patients had returned to full activities without functional limitations or pain and were satisfied with the outcome of the surgery. There was no recurrence of triggering or MP hyperextension deformity. The results from this study demonstrate that the trigger thumb in children with concomitant MP hyperextension laxity can be treated safely with predictable results by releasing the A1 pulley and advancing the volar plate.
1994年至2004年间，我院对7例（9个拇指）患有掌指关节（MP）过度伸展异常（>60°）的扳机指患儿进行了手术治疗，手术内容包括松解A1滑车并将MP掌侧板近端推进。患儿中有4名女孩和3名男孩（3个右手拇指、2个左手拇指和2个双侧拇指），手术时的平均年龄为46个月（范围为26至82个月）。平均随访时间为64个月（范围为1至8年）。在最后一次随访时，所有患儿均恢复了全部活动，没有功能受限或疼痛的情况，并且对手术结果感到满意。没有出现扳机现象复发或MP过度伸展畸形的情况。本研究结果表明，对于伴有MP过度伸展松弛的儿童扳机指，通过松解A1滑车和推进掌侧板可以安全有效地进行治疗，且效果可预测。
