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局麻下经皮弹响拇松解术治疗儿童扳机指。

Percutaneous release for trigger thumb in children under local anesthesia.

机构信息

Department of Orthopaedics and Traumatology, Medistanbul Hospital.

Department of Orthopaedics and Traumatology, Fulya mah, Yesilcimen sk, Şişli.

出版信息

J Pediatr Orthop B. 2023 Nov 1;32(6):599-603. doi: 10.1097/BPB.0000000000001075. Epub 2023 Mar 13.

Abstract

Trigger thumb surgery can be performed through open surgery or percutaneous release. Open surgery often requires hospitalization, an operating room, a surgical incision, and postoperative wound care; however, percutaneous release does not require hospitalization or surgery, and is relatively easier and faster. We aimed to assess the results of percutaneous A-1 pulley release using local anesthesia without hospitalization for the treatment of pediatric trigger thumb. In this retrospective study, we included patients operated on between March 2013 and August 2020 with the diagnosis of trigger thumb. The percutaneous release under local anesthesia was applied to all the children by one orthopedic surgeon. All percutaneous release procedures were performed in outpatient clinic conditions. There were 183 children (218 thumbs) who were enrolled in the clinic. Eighty-seven patients were male (47.5%) and 96 were female (52.5%). The average follow-up duration was 5 years (1-8.5 years). Among the 218 trigger thumb cases, 211 were satisfactory (successful result rate 96.8%). Relapse was seen in only 3 thumbs in the early postoperative period. No patient experienced neurovascular deficit or infection. The percutaneous surgical release in pediatric trigger thumb treatment is a simple, minimally invasive procedure that can be done in an outpatient setting under local anesthesia. In addition, the procedure duration is short and has minimal complication rates and maximum patient satisfaction. Level of Evidence III.

摘要

弹响拇手术可通过开放性手术或经皮松解来完成。开放性手术通常需要住院、手术室、手术切口和术后伤口护理;然而,经皮松解不需要住院或手术,相对更容易且更快。我们旨在评估局部麻醉下经皮 A1 滑车松解术治疗小儿弹响拇的结果,无需住院。在这项回顾性研究中,我们纳入了 2013 年 3 月至 2020 年 8 月期间诊断为弹响拇的手术患者。由一名骨科医生对所有儿童实施经皮局部麻醉松解术。所有经皮松解术均在门诊条件下进行。共有 183 名儿童(218 个拇指)在门诊接受治疗。87 名患者为男性(47.5%),96 名患者为女性(52.5%)。平均随访时间为 5 年(1-8.5 年)。在 218 例弹响拇病例中,211 例满意(成功率 96.8%)。术后早期仅 3 个拇指复发。无患者出现神经血管缺损或感染。经皮手术松解治疗小儿弹响拇是一种简单、微创的方法,可以在局麻下于门诊进行。此外,该手术过程时间短,并发症发生率低,患者满意度高。证据等级 III。

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