Weiss Noah D, Richter Madeline B
Weiss Orthopaedics, Sonoma, CA.
Am J Orthop (Belle Mead NJ). 2017 Jul/Aug;46(4):E263-E267.
Stenosing flexor tenosynovitis, or trigger finger, has been treated with open, endoscopic, and percutaneous tendon sheath incisions. A comparison of techniques highlights increased cost, procedure time, and postoperative recovery associated with open surgical treatment. We conducted a study of the efficacy of percutaneous tendon sheath incision as a treatment for trigger digit. Using percutaneous tendon sheath incisions, a single surgeon treated 596 trigger digits (429 patients) over a 10-year period. Successful release was defined as symptom relief on follow-up, or patient request for no further treatment. There were 537 successful releases (90.1%). Of the 59 failures, 17 underwent another percutaneous procedure (15 successful) and 40 underwent open surgical release (100% successful); 2 patients requested no further treatment. There were no significant differences in digit success rates and no complications. The success rate of this method was comparable to rates reported for open surgical procedures, but there were no instances of infection, chronic pain, or tendon or neurovascular damage. Percutaneous release is a safe, effective, and economical treatment option for trigger digits.
狭窄性屈指肌腱腱鞘炎,即扳机指,已采用开放性、内镜下和经皮腱鞘切开术进行治疗。技术比较显示,开放性手术治疗的成本更高、手术时间更长且术后恢复时间更长。我们开展了一项关于经皮腱鞘切开术治疗扳机指疗效的研究。在10年期间,由一名外科医生采用经皮腱鞘切开术治疗了596个扳机指(共429例患者)。成功松解定义为随访时症状缓解或患者要求不再接受进一步治疗。共有537例成功松解(成功率90.1%)。在59例失败病例中,17例接受了再次经皮手术(15例成功),40例接受了开放性手术松解(100%成功);2例患者要求不再接受进一步治疗。各手指的成功率无显著差异,也未出现并发症。该方法的成功率与开放性手术报道的成功率相当,但未出现感染、慢性疼痛或肌腱或神经血管损伤的情况。经皮松解是治疗扳机指的一种安全、有效且经济的治疗选择。