National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia.
PLoS One. 2023 May 30;18(5):e0286301. doi: 10.1371/journal.pone.0286301. eCollection 2023.
We aimed to investigate the association between flexor tendon degeneration and outcome of open trigger digit release. We recruited 162 trigger digits (136 patients) who had open trigger digit release from February 2017 to March 2019. Intraoperatively, six features of tendon degenerations were identified: irregular tendon surface, tendon fraying, intertendinous tear, synovial thickening, hyperaemia of sheath and tendon dryness. Longer duration of preoperative symptoms was associated with worsening tendon surface irregularity and fraying; increased number of steroid injections was associated with worsening tendon surface irregularity and dryness; higher DASH score was associated with severe tendon fraying, dryness and intertendinous tear; limited proximal interphalangeal joint (PIPJ) motion was associated with severe tendon dryness. At 1-month post-surgery, DASH score remained high in severe intertendinous tear group while PIPJ motion remained limited in severe tendon dryness group. In conclusion, the severity of various flexor tendon degenerations influenced the outcome of open trigger digit release at 1-month but did not affect the outcome at 3- and 6-months post-surgery.
我们旨在研究伸肌腱退变与开放式扳机指松解术疗效的关系。我们招募了 162 例(136 名患者)自 2017 年 2 月至 2019 年 3 月接受开放式扳机指松解术的患者。术中发现肌腱退变有 6 种特征:肌腱表面不规则、肌腱磨损、肌腱间撕裂、滑膜增厚、鞘内充血和肌腱干燥。术前症状持续时间较长与肌腱表面不规则和磨损加重相关;类固醇注射次数增加与肌腱表面不规则和干燥加重相关;DASH 评分较高与严重的肌腱磨损、干燥和肌腱间撕裂相关;近节指间关节(PIPJ)活动受限与严重的肌腱干燥相关。术后 1 个月,严重肌腱间撕裂组的 DASH 评分仍然较高,而严重肌腱干燥组的 PIPJ 活动仍然受限。总之,各种伸肌腱退变的严重程度影响开放式扳机指松解术后 1 个月的疗效,但不影响术后 3 个月和 6 个月的疗效。