Pope D F, Wolfe S W
Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT 06520-8071, USA.
J Hand Surg Am. 1995 Mar;20(2):280-3. doi: 10.1016/S0363-5023(05)80026-7.
Twenty-five A1 pulleys in 5 fresh cadaveric hands and 13 trigger fingers in 11 patients were released percutaneously with a 19 gauge needle, as described by Eastwood et al., to determine the efficacy and safety of the technique. Over 90% of the length of each individual finger and thumb A1 pulley were successfully released in the cadaveric digits with no injuries to the A2 pulley, nerves, or vessels. Superficial abrasions were noted in four superficialis tendons. In our surgical series, complete clinical release (eradication of triggering) was achieved in each digit. In 8 of 13 digits, the A1 pulley was found to be completely divided on open exploration. In five digits, while triggering was eliminated, some of the A1 pulley remained intact. There were no complications. Because of the proximity of digital nerves, we do not perform percutaneous release in the index finger or thumb.
按照伊斯特伍德等人的描述,用19号针头经皮松解了5只新鲜尸体手上的25个A1滑车以及11例患者的13个扳机指,以确定该技术的有效性和安全性。在尸体手指中,每个手指和拇指的A1滑车超过90%的长度被成功松解,且A2滑车、神经或血管均未受损。在四条指浅屈肌腱上发现了浅表擦伤。在我们的手术系列中,每个手指均实现了完全临床松解(消除扳机现象)。在13个手指中的8个,术中探查发现A1滑车完全断裂。在5个手指中,虽然扳机现象消除了,但部分A1滑车仍保持完整。没有出现并发症。由于指神经位置接近,我们不在示指或拇指进行经皮松解。