Park Kwang-Hee, Shin Won-Jeong, Kim Sung-Joon, Kim Jong-Pil
From the Department of Orthopedic Surgery, College of Medicine, and Department of Kinesiology and Medical Science, Graduate School, Dankook University, Cheonan, Korea.
Ann Plast Surg. 2018 Nov;81(5):537-543. doi: 10.1097/SAP.0000000000001561.
We aimed to inspect bowstringing after percutaneous and open release of the A1 pulley for trigger digits and its influence on hand function. Sixty-two patients with a resistant trigger digit were randomized to undergo either open release or percutaneous release of the A1 pulley. We quantified bowstringing of the digit using ultrasonography preoperatively and at 12 and 24 weeks after surgery. Pain on a visual analog scale; Disabilities of the Arm, Shoulder, and Hand questionnaire; pinch power; and grip strength were assessed. Bowstringing was significantly increased at 12 weeks after surgery in both groups, and the mean value of the open release group was significantly greater than that of the percutaneous group (2.30 ± 0.58 mm vs 1.46 ± 0.51 mm, respectively; P = 0.035). However, the bowstringing was decreased at 24 weeks without showing significant difference between the 2 groups. The clinical outcomes of each cohort improved significantly, with no difference between the groups at final follow-up. No association was found between bowstringing and any clinical outcome measure. Bowstringing occurred by A1 pulley release with either the percutaneous or open technique does not affect clinical hand function in patients with trigger fingers.
我们旨在检查经皮和开放性松解A1滑车治疗扳机指后弓弦状畸形及其对手部功能的影响。62例顽固性扳机指患者被随机分为接受A1滑车开放性松解或经皮松解两组。我们在术前以及术后12周和24周使用超声对手指的弓弦状畸形进行量化。评估视觉模拟量表疼痛评分、手臂、肩部和手部功能障碍问卷、捏力和握力。两组患者术后12周时弓弦状畸形均显著增加，且开放性松解组的平均值显著高于经皮松解组（分别为2.30±0.58mm和1.46±0.51mm；P = 0.035）。然而，24周时弓弦状畸形减小，两组间无显著差异。各队列的临床结局均显著改善，末次随访时两组间无差异。未发现弓弦状畸形与任何临床结局指标之间存在关联。经皮或开放性技术行A1滑车松解后出现的弓弦状畸形不影响扳机指患者的临床手部功能。
