Park Il-Jung, Lee Yoon-Min, Kim Hyoung-Min, Lee Jae-Young, Roh Youn-Tae, Park Chang-Kyun, Kang Soo-Hwan
Department of Orthopaedic Surgery, Bucheon St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Orthopaedic Surgery, St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
J Plast Reconstr Aesthet Surg. 2016 Mar;69(3):335-40. doi: 10.1016/j.bjps.2015.10.030. Epub 2015 Oct 30.
Trigger wrist, a relatively unusual condition, is a triggering at the wrist produced by wrist or finger motion. The clinical manifestations and surgical results of trigger wrist with multiple etiologies were evaluated.
From October 2008 to December 2012, this study retrospectively reviewed 15 patients diagnosed with trigger wrist. The patients comprised six men and nine women with a mean age of 44.8 years (range, 29-86 years). The mean follow-up period was 16.2 months (range, 11-30 months).
The causes of trigger wrist were an anomalous muscle belly of the flexor digitorum superficialis (n = 5), severe tenosynovitis of the flexor tendon (n = 4), fibroma around the flexor tendon sheath (n = 2), a rheumatoid nodule (n = 1), both anomalous muscle belly and tenosynovitis (n = 1), a ganglion (n = 1), and pigmented villonodular synovitis (n = 1). Mild-to-moderate symptoms of median neuropathy without thenar muscle atrophy were present in all patients. Postoperatively, all patients recovered well with resolution of median nerve symptoms, and the wrist triggering was absent.
Trigger wrist is a relatively rare condition compared with trigger finger, which is the most common disorder of the hand. To avoid inadequate and ineffective treatment of patients with trigger wrist, careful examination and proper diagnosis are vital.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic/IV.
扳机指腕是一种相对少见的病症,是由腕部或手指活动引起的腕部卡顿现象。本研究评估了多种病因导致的扳机指腕的临床表现及手术效果。
2008年10月至2012年12月,本研究回顾性分析了15例诊断为扳机指腕的患者。患者包括6名男性和9名女性,平均年龄44.8岁(范围29 - 86岁)。平均随访时间为16.2个月(范围11 - 30个月)。
扳机指腕的病因包括:指浅屈肌异常肌腹(5例)、屈肌腱重度腱鞘炎(4例)、屈肌腱鞘周围纤维瘤(2例)、类风湿结节(1例)、异常肌腹合并腱鞘炎(1例)、腱鞘囊肿(1例)、色素沉着绒毛结节性滑膜炎(1例)。所有患者均有轻度至中度正中神经病变症状,但无大鱼际肌萎缩。术后,所有患者恢复良好,正中神经症状消失,腕部卡顿现象也消失。
与手部最常见的扳机指相比,扳机指腕相对少见。为避免对扳机指腕患者治疗不足或无效,仔细检查和正确诊断至关重要。
研究类型/证据水平:治疗性研究/四级。