de Oliveira Ricardo Kaempf, Delgado Pedro J, Geist João Guilherme Brochado
Santa Casa and Mãe de Deus Hospitals, Porto Alegre, Brazil.
Hospital Universitario HM Montepríncipe, Boadilla del Monte, Madrid, Spain.
Hand (N Y). 2017 Jan;12(1):99-105. doi: 10.1177/1558944715627634. Epub 2016 Mar 3.
The trigger finger is characterized by the painful blocking of finger flexor tendons of the hand, while crossing the A1 pulley. It is a rare disease in children and, when present, is usually located in the thumb, and does not have any defined cause. We report 2 pediatric trigger finger cases affecting the long digits of the hand that were caused by an osteochondroma located at the proximal phalanx. Both children held the diagnosis of juvenile multiple osteochondromatosis. They had presented at the initial visit with a painful finger blocking. Surgical approach was decided with wide regional exposure, as compared with the trigger finger traditional surgical techniques, with the opening of the A1 pulley and the initial portion of the A2 pulley, along with bone tumor resection. Patients evolved uneventfully, and recovered the affected finger motion. It is important to highlight that pediatric trigger finger is a distinct ailment from the adult trigger finger, and also in children is important to differentiate whenever the disease either affects the thumb or the long fingers. A secondary cause shall be sought whenever the long fingers are affected by a trigger finger.
扳机指的特征是手部手指屈肌腱在穿过A1滑车时出现疼痛性卡顿。这是一种在儿童中罕见的疾病,一旦出现,通常位于拇指,且没有明确病因。我们报告2例小儿扳机指病例,累及手部的长手指,病因是位于近节指骨的骨软骨瘤。两名儿童均被诊断为青少年多发性骨软骨瘤病。他们初次就诊时均表现为手指疼痛性卡顿。与扳机指传统手术技术相比,手术方式决定采用广泛的区域暴露,切开A1滑车和A2滑车的起始部分,同时切除骨肿瘤。患者病情平稳进展,受影响手指的活动得以恢复。需要强调的是,小儿扳机指与成人扳机指是不同的疾病,而且在儿童中,区分疾病是影响拇指还是长手指也很重要。当长手指受扳机指影响时,应寻找继发原因。