针对扳机指松解术后效果不佳的情况,采用微创尺骨浅肌滑脱切除术的疗效。

Satoshi Usami, Sanshiro Kawahara, Kohei Inami, Kentaro Sonoki, Masashi Takemitsu
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引用次数: 0

摘要

背景:本研究旨在评估尺骨浅层滑脱切除术(USSR)在使用微创方法进行扳指松解术后效果不佳的情况下改善手部功能的疗效。方法:我们对 16 名患者的 17 根连续手指进行了评估,这些患者在接受了原发性扳机指松解术后抱怨效果不佳。其中 2 个食指和 15 个中指的主要主诉是活动时近端指间关节(PIP)疼痛、PIP 关节屈曲挛缩以及 A2 滑轮处折断,分别为 8 个手指、7 个手指和 2 个手指。术前和术后评估了PIP关节活动范围的关节弧度和伸展损失、握力、PIP关节疼痛的视觉模拟评分(VAS)以及手臂、肩部和手部的快速残疾程度。结果显示通过苏联手术,13 个手指可以解除关节挛缩和折断。但有三名患者的四根手指需要进行屈指浅肌全切除术,以解决术中判定的不满意情况。PIP关节的关节弧主动活动范围和伸展损失、握力和VAS评分明显改善(平均随访16.1个月)。最后,15 名患者(88.2%)对症状缓解结果表示满意。结论对于扳机指松解术后的不良症状,包括 PIP 关节疼痛、关节挛缩和 A2 滑轮处折断,USSR 是一种有效且令人满意的手术。证据等级:四级(治疗)。
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Efficacy of Minimally Invasive Ulnar Superficialis Slip Resection for Unfavourable Results after Trigger Finger Release.

Background: 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. Methods: 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. Results: 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. Conclusions: 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 of Evidence: Level IV (Therapeutic).

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