微创松解疗法治疗指屈肌腱狭窄性腱鞘炎研究

Research on minimally invasive release treatment of stenosing tenosynovitis of flexor digitorum

中医小针刀微创松解疗法治疗指屈肌腱狭窄性腱鞘炎——"扳机指",具有比较满意的疗效。近年来许多临床医生利用自制小尖刀、斜刃刀、虹膜刀、镰状弯刀、推割刀等改进刀具替代传统小针刀,改变原小针刀垂直多刀刺切法,采取微型切口,沿指屈肌腱走行方向纵向钩切、挑割、直线推割等方式,彻底切开出现狭窄病变的腱鞘滑车,达到松解目的。术中需要注意:全面细致地了解指屈肌腱以及周围组织的解剖层次、结构关系;严格掌握指屈肌腱狭窄性腱鞘炎微创松解疗法的适应证;熟练掌握专用微创松解针、刀具以及规范化操作方法;术前准确定位,术中按顺指屈肌腱走行方向,沿肌腱正中连续切开松解的方法,完全可以达到与传统切开手术相同甚至更高的松解疗效,同时还可避免常见不良并发症的发生。

The minimally invasive release treatment of TCM Small Needle-Knife for the stenosing tenosynovitis of flexor digtorum-＂trigger finger＂ has a more satisfied efficacy. In recent years, many clinicians use self-made small sharp scalpels, iris knives,small sickles,push shear knives,and other improved alternatives to instead of the traditional small needle-knives. Changing the original small needle-knife vertical stabbed cutting method, take a mini-incision, along the traveling direction of flexor tendon make a vertical hook cut,pick cut, straight push cut and any other cuts, completely cut the stenosis of the tendon sheath pulley ,to achieve the release therapeutic purposes. The experience of most scholars is：Detailed and thorough under- standing refers to the anatomical level of the flexor tendon and surrounding tissue, the structural relationship ; Strictly adhere to the indications of minimally invasive release therapy; Proficiency in a dedicated minimally invasive release needle-knives, scalpels, and standardized methods of operation ; Accurate positioning before surgery, in surgery traveling direction along flexor tendon, continuous incision to release the middle along the tendon. It can achieve the same or even higher incision release effi- cacy than the traditional treatment, at the same time also avoids common adverse complications.