Department of Hand Surgery, Tokyo Hand Surgery & Sports Medicine Institute, Takatsuki Orthopaedic Hospital, Tokyo, Japan.
J Hand Surg Asian Pac Vol. 2024 Feb;29(1):24-28. doi: 10.1142/S2424835524500048.
This study aimed to evaluate the efficacy of ulnar superficial slip resection (USSR) for improving hand function after unfavourable results after triggering finger release using a minimally invasive approach. We evaluated 17 consecutive fingers of 16 patients who complained of unfavourable outcomes after primary trigger finger release. The chief complaints of the two index and 15 middle fingers were proximal interphalangeal (PIP) joint pain during movement, flexion contracture of the PIP joint and snapping at the A2 pulley in eight, seven and two fingers, respectively. The joint arc of the active range of motion and extension loss of the PIP joint, grip strength, visual analogue score (VAS) of PIP joint pain and Quick Disability of the Arm, Shoulder and Hand were evaluated before and after surgery. Thirteen fingers could release joint contracture and snapping by the USSR procedure. However, four fingers of three patients required total flexor digitorum superficialis resection to resolve the unsatisfactory conditions of the intraoperative decision. The joint arc of active range of motion and extension loss of the PIP joint, grip strength and VAS score significantly improved (mean of 16.1 months follow-up). Finally, 15 patients (88.2%) were satisfied with the symptom relief outcomes. USSR is an effective and satisfactory procedure for unfavourable conditions after trigger finger release, including PIP joint pain, joint contracture and snapping at the A2 pulley. Level IV (Therapeutic).
本研究旨在评估尺侧浅滑囊切除术(USSR)在微创入路治疗扳机指松解术后不良结果中的疗效,以改善手部功能。我们评估了 16 名患者的 17 个连续手指,这些患者在初次扳机指松解后出现不良结果。2 个食指和 15 个中指的主要抱怨是活动时近节指间关节(PIP)疼痛、PIP 关节屈曲挛缩和 A2 滑车处弹响,分别在 8、7 和 2 个手指中出现。手术前后评估主动活动度的关节弧和 PIP 关节伸展损失、握力、PIP 关节疼痛的视觉模拟评分(VAS)和上肢残疾问卷。通过 USSR 手术,13 个手指可以释放关节挛缩和弹响。然而,3 名患者的 4 个手指需要进行总屈指浅肌切除术,以解决术中决策的不满意情况。主动活动度的关节弧和 PIP 关节伸展损失、握力和 VAS 评分显著改善(平均随访 16.1 个月)。最后,15 名患者(88.2%)对症状缓解结果满意。USSR 是治疗扳机指松解术后不良情况(包括 PIP 关节疼痛、关节挛缩和 A2 滑车处弹响)的有效且满意的方法。 四级(治疗)。