Messina A, Messina J C
Traumatologic and Orthopaedic Hospital, Torino, Italy.
J Hand Surg Br. 1996 Aug;21(4):463-8. doi: 10.1016/s0266-7681(96)80047-7.
The direct midlateral approach and the lateral enlarging procedure of the pulley system have been utilized in our service since 1972. The incision runs directly behind the neurovascular pedicle, which is left in the palmar skin flap of the anterior compartment of the finger, in order to ensure its blood supply and sensibility. The transverse digital lamina of Landsmeer's skin anchoring system and Cleland's ligament are preserved and are used to perform a lateral enlargement of the pulleys after tendon repair. The technique allows wide surgical exposure of the digital fibro-osseous tunnel, enlargement and reconstruction of the pulley system and tendon sheath, flexor tendon repair (using the technique of choice) and reduces postoperative impingement in zone 2.
自1972年起，我们就开始采用直接外侧入路和滑轮系统外侧扩大术。切口直接位于神经血管蒂后方，该神经血管蒂保留在手指前侧间室的掌侧皮瓣中，以确保其血液供应和感觉功能。保留兰斯米尔皮肤锚定系统的横行指板和克莱兰韧带，并在肌腱修复后用于进行滑轮的外侧扩大。该技术可实现对指纤维骨隧道的广泛手术显露、滑轮系统和腱鞘的扩大及重建、屈指肌腱修复（采用所选技术），并减少2区的术后卡压。
