Amrani A, Dandane M A, Alami Z F El
Service d'orthopédie et chirurgie réparatrice, hôpital d'enfants, Rabat, Maroc.
Chir Main. 2011 Apr;30(2):102-4. doi: 10.1016/j.main.2011.01.012. Epub 2011 Feb 26.
Congenital trigger thumb is secondary to a conflict between the flexor pollicis longus tendon and its inextensible tendon sheath. Though, the exact aetiology is still unknown, its treatment is usually surgical.
The authors present their experience of treating 52 consecutive patients with 63 trigger thumbs, with mean age 32 months, range (12 months to five years). Twenty-nine boys and 23 girls. Right thumb 37 and left thumb 26, 11 patients had have bilateral trigger thumb. Each was exclusively treated by percutaneous release of the A1 pulley using a needle.
Fifty-two with 50 treated trigger thumbs were available for follow-up. The mean follow-up after this procedure was 28 months (range 12-30 months). Fourty-eight thumbs had a good result without any recurrence of triggering. Two thumbs had recurrent triggering and were subsequently successfully treated by open release. No thumbs demonstrated any neurovascular deficit clinically.
Percutaneous release of congenital trigger thumb can be performed safely and effectively in children by a surgeon specializing in hand surgery.
先天性扳机指继发于拇长屈肌腱与其不可伸展的腱鞘之间的冲突。尽管确切病因仍不清楚，但其治疗通常为手术治疗。
作者介绍了他们连续治疗52例患者共63个扳机指的经验，患者平均年龄32个月，范围为（12个月至5岁）。其中29名男孩和23名女孩。右侧拇指37例，左侧拇指26例，11例患者为双侧扳机指。每例均采用针经皮松解A1滑车进行单独治疗。
52例患者中50个接受治疗的扳机指可供随访。该手术后的平均随访时间为28个月（范围12 - 30个月）。48个拇指效果良好，未出现扳机现象复发。2个拇指出现扳机现象复发，随后通过切开松解成功治疗。临床上无拇指出现任何神经血管缺损。
小儿先天性扳机指经皮松解术可由手外科专科医生安全有效地实施。
