套管定位针刀微创治疗弹响指的疗效观察

Treatment of trigger finger with located needle knife

目的 ：探讨套管定位针刀微创治疗弹响指的临床疗效。方法 ：回顾性分析2010年9月至2014年3月采用自制的套管定位针刀微创治疗弹响指患者133例（145指）,男37例（40指）,女96例（105指）;年龄18~71岁,平均51.8岁;病程1~19个月,平均8.2个月;拇指82指,示指12指,中指11指,环指36指,小指4指。根据Quinnell分级标准：Ⅲ级42指,Ⅳ级92指,Ⅴ级11指。术中先将套管凹槽卡入肥厚腱鞘的远侧,再向近侧沿肌腱走行方向以小针刀铲割松解。观察创口愈合情况、有无指血管神经损伤和术后6个月患指疼痛及屈伸功能。结果：手术时间8~25 min,平均9.8 min。145患指均无创口红肿、渗液,无指血管神经损伤等不良反应发生。133例患者均获随访,时间6~26个月,平均12.5个月。术后6个月复查按照Quinnell分级标准,优123指,良15指,差7指。结论：套管定位针刀微创治疗弹响指是一种创伤小、安全简单、疗效可靠的好方法,值得临床推广。

Objective：To investigate the clinical effects of located needle knife in the treatment of trigger finger. Methods：The clinical data of 133 patients（145 fingers） with trigger finger underwent treatment with located needle knife from September 2010 to March 2014 were retrospectively analyzed. There were 37 males（40 fingers） and 96 females（105 fingers）,aged from 18 to 71 years old with a mean of 51.8 years. Course of disease was from 1 to 19 months with an average of 8.2months. Affected fingers included 82 thumbs,12 index fingers,11 middle fingers,36 ring fingers,and 4 little fingers. According to the standard of Quinnell grade,42 fingers were grade Ⅲ,92 fingers were grade Ⅳ,and 11 fingers were gradeⅤ. Firstly the double pipe gab was put into the distal edge of hypertrophic tendon sheath,then small knife needle was used to release the sheath proximally along the tendon line direction. The informations of wound healing and nerve injury,postoperative finger function,finger pain at 6 months were observed. Results：The operation time was from 8 to 25 min with an average of 9.8 min.All the patients were followed up from 6 to 26 months with an average of 12.5 months. No complications such as the wound inflammation and seepage,vascular or nerve injuries were found. According to the standard of Quinnell grade,123 fingers got excellent results,15 good,7 poor. Conclusion：It＇s a good choice to treat trigger finger with located needle knife in advantage of minimal invasion,simple safe operation,and it should be promoted in clinic.