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A1 滑车切开术后持续性扳机指患者行指浅屈肌尺侧腱束原发性切除术

Primary Resection of the Ulnar Slip of Flexor Digitorum Superficialis in the Persistently Triggering Patient After A1 Pulley Release.

机构信息

Lenox Hill Hospital - Northwell Health, New York, NY, USA.

出版信息

Hand (N Y). 2023 Sep;18(6):954-959. doi: 10.1177/15589447211073829. Epub 2022 Feb 8.

Abstract

BACKGROUND

The purpose of this study was to determine the occurrence of patients undergoing primary trigger finger release (TFR) that underwent ulnar superficialis slip resection (USSR) for decompression and to determine which digit was most commonly affected.

METHODS

A retrospective chart review was conducted of all cases of open TFR performed by a single surgeon. The following data were obtained: age, sex, laterality, affected digit, and consideration for USSR. All patients failed nonoperative treatment of at least 1 steroid injection. The occurrence of patients who underwent TFR and USSR and which digit(s) most commonly underwent USSR were determined. The average patient age that underwent USSR, frequency by sex, and relative occurrence of USSR in each digit were computed. Statistical calculations were conducted using χ analysis ( < .05).

RESULTS

A total of 911 primary open TFRs were performed in 631 patients over a 16-year period. A total of 20 TFRs in 20 patients underwent USSR (2.2%). The long finger was the most commonly affected digit (40%) that required simple decompression. Within all USSR cases, the long finger was the most commonly affected digit. The index finger was the second most affected (30%), and there were no cases in the small finger.

CONCLUSIONS

This study determined the occurrence of primary TFR cases that underwent USSR, with the long finger being the most commonly affected digit. Surgeons may consider this additional procedure to perform a larger decompression than simple A1 pulley release alone.

摘要

背景

本研究旨在确定行原发性扳机指松解术(TFR)的患者中,行尺侧腕伸肌腱滑脱切除术(USSR)减压的发生率,并确定哪个手指最常受影响。

方法

对一位外科医生行的所有开放性 TFR 病例进行回顾性图表审查。获得以下数据:年龄、性别、侧别、受累手指和考虑行 USSR。所有患者均经至少 1 次类固醇注射的非手术治疗失败。确定行 TFR 和 USSR 的患者以及最常行 USSR 的手指。计算行 USSR 的患者的平均年龄、性别频率以及每个手指的 USSR 相对发生率。使用卡方检验(<0.05)进行统计计算。

结果

在 16 年期间,共有 631 例患者行 911 例原发性开放性 TFR。20 例患者中的 20 例 TFR 行 USSR(2.2%)。最长的手指是最常受影响的手指(40%),需要单纯减压。在所有 USSR 病例中,最长的手指是最常受影响的手指。食指是第二常见的受累手指(30%),而小指没有病例。

结论

本研究确定了行 USSR 的原发性 TFR 病例的发生率,最长的手指是最常受影响的手指。外科医生可能会考虑进行这种附加手术,以进行比单纯 A1 滑车松解更大的减压。

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