Fox Mary P, McKay Jack E, Craver Randall D, Pappas Nicholas D
Orthopedics. 2017 Sep 1;40(5):e918-e920. doi: 10.3928/01477447-20170518-01. Epub 2017 May 22.
A trigger digit is relatively uncommon in adolescents and often has a different etiology in that age group vs adults. In the pediatric population, trigger digits frequently arise from a variety of underlying anatomic situations, including thickening of the flexor digitorum superficialis or flexor digitorum profundus tendons, an abnormal relationship between the flexor digitorum superficialis and flexor digitorum profundus tendons, a proximal flexor digitorum superficialis decussation, or constriction of the pulleys. In addition, underlying conditions such as mucopolysaccharidosis, juvenile rheumatoid arthritis, Ehlers-Danlos syndrome, and central nervous system disorders such as delayed motor development have been associated with triggering. Less commonly, triggering secondary to intratendinous or peritendinous calcifications or granulations has been described, which is what occurred in the current case. This report describes a case of tenosynovitis with psammomatous calcification treated with excision of the mass from the flexor digitorum superficialis tendon and release of both the A1 and palmar aponeurosis pulleys in an adolescent patient. [Orthopedics. 2017; 40(5):e918-e920.].
扳机指在青少年中相对少见,且在该年龄组与成人相比往往病因不同。在儿科人群中,扳机指常由多种潜在的解剖学情况引起,包括指浅屈肌腱或指深屈肌腱增厚、指浅屈肌腱与指深屈肌腱之间的异常关系、指浅屈肌腱近端交叉或滑车狭窄。此外,诸如黏多糖贮积症、幼年类风湿关节炎、埃勒斯-当洛综合征等潜在疾病以及诸如运动发育迟缓等中枢神经系统疾病也与扳机指有关。较少见的是,曾有继发于肌腱内或肌腱周围钙化或肉芽形成的扳机指的描述,本病例即为此种情况。本报告描述了一名青少年患者,通过切除指浅屈肌腱肿物并松解A1滑车和掌腱膜滑车,治疗了伴有砂粒体样钙化的腱鞘炎。[《骨科》。2017;40(5):e9~e920。]