Giugale Juan M, Fowler John R
Department of Orthopaedic Surgery, University of Pittsburgh, Suite 1010, Kaufmann Building, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA.
Department of Orthopaedic Surgery, University of Pittsburgh, Suite 1010, Kaufmann Building, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA.
Orthop Clin North Am. 2015 Oct;46(4):561-9. doi: 10.1016/j.ocl.2015.06.014. Epub 2015 Aug 13.
Trigger fingers are common tendinopathies representing a stenosing flexor tenosynovitis of the fingers. Adult trigger finger can be treated nonsurgically using activity modification, splinting, and/or corticosteroid injections. Surgical treatment options include percutaneous A1 pulley release and open A1 pulley release. Excision of a slip of the flexor digitorum superficialis is reserved for patients with persistent triggering despite A1 release or patients with persistent flexion contracture. Pediatric trigger thumb is treated with open A1 pulley release. Pediatric trigger finger is treated with release of the A1 pulley with excision of a slip or all of the flexor digitorum superficialis if triggering persists.
扳机指是常见的肌腱病,表现为手指屈指肌腱狭窄性腱鞘炎。成人扳机指可通过改变活动方式、使用夹板和/或注射皮质类固醇进行非手术治疗。手术治疗选择包括经皮A1滑车松解术和开放性A1滑车松解术。对于尽管进行了A1松解仍持续出现扳机现象的患者或存在持续性屈曲挛缩的患者,可选择切除部分指浅屈肌腱。小儿扳机拇指采用开放性A1滑车松解术治疗。小儿扳机指若扳机现象持续存在,则采用A1滑车松解术并切除部分或全部指浅屈肌腱进行治疗。