Werthel J-D, Cortez M, Elhassan B T
Department of Orthopedic Surgery, Mayo Clinic, 200, First Street S.W., Rochester, MN 55905, USA.
Department of Hand Surgery, Sos Mão Recife, 147, Rua Minas Gerais, Ilha do Leite, Recife, PE, 50070-410, Brazil.
Hand Surg Rehabil. 2016 Jun;35(3):179-182. doi: 10.1016/j.hansur.2016.02.004. Epub 2016 Mar 14.
Stenosing tenosynovitis or trigger finger is one of the most common disorders that affect the flexor tendon apparatus of the hand. Percutaneous release has been previously reported to be easier, quicker, less invasive and less costly than open surgery. The purpose of this study was to report the outcome of an alternative percutaneous trigger finger release technique. From March 2008 to January 2014, 92 patients (128 fingers) who underwent the alternative percutaneous trigger finger release, with a minimum of 6 months follow-up were included. Outcomes included size of skin incision, pain, residual symptoms, satisfaction and complications. Percutaneous release was achieved in all fingers, except 1 for which an opening of the skin was necessary to complete the release of the pulley. Eight fingers (6%) required revision open surgery because of persistence of their symptoms. At 1 week after the procedure, no finger swelling was reported, however 4 fingers (3%) were painful and 45 (35%) were stiff and required physiotherapy. Percutaneous release was successful in 120 fingers (94%). At the final follow-up, all the patients were satisfied by the procedure (95 rated their result as much better and 32 as better). This study shows that our alternative percutaneous trigger finger release is a reliable and safe procedure with high patient satisfaction.
Level IV, clinical study, therapeutic study.
狭窄性腱鞘炎或扳机指是影响手部屈肌腱装置的最常见疾病之一。此前有报道称，经皮松解术比开放手术更容易、更快、侵入性更小且成本更低。本研究的目的是报告一种替代性经皮扳机指松解技术的结果。从2008年3月至2014年1月，纳入了92例患者（128指），他们接受了替代性经皮扳机指松解术，且至少随访6个月。结果包括皮肤切口大小、疼痛、残留症状、满意度和并发症。除1指因需切开皮肤以完成滑车松解外，所有手指均成功进行了经皮松解。8指（6%）因症状持续需要进行翻修开放手术。术后1周，未报告手指肿胀，但有4指（3%）疼痛，45指（35%）僵硬，需要物理治疗。120指（94%）经皮松解成功。在最后随访时，所有患者对该手术都很满意（95例将结果评为好得多，32例评为较好）。本研究表明，我们的替代性经皮扳机指松解术是一种可靠、安全的手术，患者满意度高。
IV级，临床研究，治疗性研究。
