Bamroongshawgasame Thana
Division of Orthopedic Surgery, Ratchaburi Hospital, Ratchaburi, Thailand.
J Med Assoc Thai. 2010 Feb;93(2):199-204.
To compare the results of open surgery with those of percutaneous surgery in patients with trigger digits.
One hundred forty two patients with 160 trigger fingers and thumbs were prospectively randomized to either open (70 patients, 80 digits) or percutaneous (72 patients, 80 digits) surgeries at Ratchaburi Hospital. The operations were performed by one surgeon between May 1, 2007 and Dec 31, 2008. Operative time, postoperative range of motion of the finger proximal interphalangeal joint (PIP) or thumb interphalangeal joint (IP), patient satisfaction score, patient pain score, and surgical complications were assessed at weeks 1, 2, 3, 4, 6, and 8.
Trigger digits were successfully treated in eighty digits (100%) of the patients who underwent open surgery and in seventy-nine digits (98.75%) of the patients who underwent percutaneous surgery. Mean operative time, mean postoperative range of motion of the finger PIP or thumb IP, mean postoperative satisfaction score, and mean postoperative patient pain score were not significantly different between the groups. No serious complications were observed in either group. One patient in the percutaneous surgery group underwent open surgery two months later due to pain and locking.
Percutaneous trigger digit surgery using the full handle knife 45 degrees is effective and safe, and results functional outcomes equal to those with open trigger digit surgery.
比较扳机指患者开放手术与经皮手术的效果。
142例患有160个扳机指和扳机拇指的患者前瞻性随机分为在叻丕府医院接受开放手术（70例患者，80个手指）或经皮手术（72例患者，80个手指）两组。手术由一名外科医生在2007年5月1日至2008年12月31日期间进行。在第1、2、3、4、6和8周评估手术时间、术后手指近端指间关节（PIP）或拇指指间关节（IP）的活动范围、患者满意度评分、患者疼痛评分和手术并发症。
接受开放手术的患者中80个手指（100%）的扳机指得到成功治疗，接受经皮手术的患者中79个手指（98.75%）的扳机指得到成功治疗。两组之间的平均手术时间、术后手指PIP或拇指IP的平均活动范围、术后平均满意度评分和术后平均患者疼痛评分无显著差异。两组均未观察到严重并发症。经皮手术组中有1例患者因疼痛和卡顿在两个月后接受了开放手术。
使用45度全柄刀进行经皮扳机指手术有效且安全，其功能结果与开放扳机指手术相当。
