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继发于被忽视的屈肌腱断裂的扳机指。

Trigger finger secondary to a neglected flexor tendon rupture.

作者信息

Lee Malrey, Jung Young-Ran, Lee Young-Keun

机构信息

The Research Center for Advanced Image and Information Technology, School of Electronics & Information Engineering, Chonbuk National University.

Department of Orthopedic Surgery, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Chonbuk, Republic of Korea.

出版信息

Medicine (Baltimore). 2019 Jan;98(1):e13980. doi: 10.1097/MD.0000000000013980.

Abstract

Secondary trigger finger caused by trauma to the hand, especially associated with partial flexor tendon rupture, is not a common condition. Thus, the clinical manifestations of these patients are not well-known. The aim of this study is to present secondary trigger finger caused by a neglected partial flexor tendon rupture including discussion of the mechanism and treatment.We retrospectively reviewed the records of 6 patients with trigger finger caused by a neglected partial flexor tendon rupture who had been treated with exploration, debridement, and repairing of the ruptured tendon from August 2010 to May 2015. The average patient age was 41 years (range, 23-59). The time from injury to treatment averaged 4.7 months. The average follow-up period was 9 months (range, 4-18). Functional outcome was evaluated from a comparison between the Quick-disabilities of the arm, shoulder, and hand (DASH) score and the visual analogue scale (VAS) for pain, which were measured at the time of preoperation and final follow up.Four patients showed partial rupture of the flexor digitorum profundus (FDP) tendon and 3 showed partial rupture of the flexor digitorun superficialis (FDS) tendon. Both the FDP and FDS tendons were partially ruptured in 2 patients, and the remaining patient had a partial rupture of the flexor pollicis longus tendon. All patients regained full range of motion, and there has been no recurrence of triggering. The average VAS score decreased from 3.6 (range, 3-5) preoperatively to 0.3 (range, 0-1) at the final follow up. The average Quick-DASH score decreased from 33.6 preoperatively to 5.3 at the final follow up.When we encounter patients with puncture or laceration wounds in flexor zone 2, even when the injury appears to be simple, partial flexor tendon laceration must be taken into consideration and early exploration is recommended.

摘要

手部创伤导致的继发性扳机指,尤其是与部分屈肌腱断裂相关的情况并不常见。因此,这些患者的临床表现尚不为人熟知。本研究的目的是介绍由被忽视的部分屈肌腱断裂引起的继发性扳机指,包括对其机制和治疗的讨论。我们回顾性分析了2010年8月至2015年5月期间6例因被忽视的部分屈肌腱断裂导致扳机指并接受了肌腱探查、清创和修复治疗的患者记录。患者平均年龄为41岁(范围23 - 59岁)。从受伤到治疗的平均时间为4.7个月。平均随访期为9个月(范围4 - 18个月)。通过比较术前和末次随访时测量的手臂、肩部和手部快速残疾评定量表(DASH)评分以及疼痛视觉模拟量表(VAS)来评估功能结果。4例患者示指深屈肌腱(FDP)部分断裂,3例患者示指浅屈肌腱(FDS)部分断裂。2例患者FDP和FDS肌腱均部分断裂,其余1例患者拇长屈肌腱部分断裂。所有患者均恢复了全范围活动,且未出现扳机指复发。VAS评分平均从术前的3.6(范围3 - 5)降至末次随访时的0.3(范围0 - 1)。Quick - DASH评分平均从术前的33.6降至末次随访时的5.3。当我们遇到屈肌2区有刺伤或裂伤的患者时,即使损伤看似简单,也必须考虑到部分屈肌腱裂伤并建议早期探查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98c3/6344173/26c9e65764ff/medi-98-e13980-g003.jpg

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