扳机指钩刀经皮松解A1腱鞘治疗指屈肌腱腱鞘炎

Percutaneous A1 Pulley Release Using a Special Hook Knife: a Clinical Study

目的:探讨通过在体表准确定位A1腱鞘,并利用自制扳机指钩刀经皮松解A1腱鞘治疗指屈肌腱腱鞘炎的临床疗效。方法:2005年3月~2010年8月使用扳机指钩刀治疗患者70例,其中女62例,男2例,年龄18~69岁,平均48岁。共86指,其中拇指67指,食指1指,中指10指,环指6指,小指2指。39指为II°,23指为III°,24指为IV°。所有病例均使用自制扳机指钩刀经皮松解A1腱鞘治疗。结果:86指随访6~24个月,平均11.5月,83指1次手术完全治愈,3指由IV°变成I^II°,再次行经皮松解,2指效果满意,另1例病人经开放手术后治愈。1例病人在手术区域有持续的疼痛,1例病人在手术区域有皮下瘀血和肿胀,这2例病人的症状均在4周复查时消失。所有病人都没发现任何术后并发症。结论:通过A1腱鞘准确的体表定位,使用扳机指钩刀经皮松解A1腱鞘治疗指屈肌腱腱鞘炎创伤小,疗效确切、迅速,简便,安全,痛苦小,费用低。

Objective： To study the effects of a special hook knife with an arched blade used to perform percutaneous A1 pulley release under local anesthesia.Methods： Eighty six trigger fingers or thumbs （grade 2-4） were ＂released＂ using this technique percutaneously. A new method was recommended to locate the A1 pulley on the skin.Results： Satisfactory results were achieved in 85 digits （98.8%）. We did not encounter any significant complications. Conclusion： We recommend this technique as a simple, safe, cost-effective, and minimally invasive procedure to treat triggering fingers without visible scarring on the skin after operation.