内窥镜下腱鞘切开治疗狭窄性腱鞘炎的初步报告

Endoscopic tendon sheath release for stenosing tenovaginitis: A preliminary report

目的 探讨内窥镜下腱鞘切开治疗狭窄性腱鞘炎的可行性。 方法 狭窄性腱鞘炎 5例 (拇指 2例、环指 2例、中指 1例 ) ,采用Smith&Nephew内镜腱鞘切开系统 ,皮肤 3 0mm切口 ,开放式外套管从切口近端沿腱鞘插入 ,从远端切口穿出 ,2 7mm关节镜从外套管近端插入 ,钩刀从远端进入 ,在内镜引导下完全切开腱鞘。 结果 5例腱鞘均完全切开 ,手术后立即恢复了手指的屈伸功能 ,术后 1周重返工作岗位 ,无明显的伤口疼痛和延迟愈合等并发症出现。 结论 本法微创 ,痛苦小 ,恢复快 ,疗效高 ,尤其适用于多个手指和伴有糖尿病的患者。

Objective To evaluate the endoscopic tendon sheath release for stenosing tenovaginitis (trigger finger). Methods Five patients with stenosing tenovaginitis (2 in thumbs, 1 in middle finger, and 2 in ring fingers) underwent operations by Smith & Nephew Endoscopic Trigger Finger Release system. After two 3.0mm transverse incisions were made, the window cannula assembly was inserted subcutaneously along the sheath from the proximal portal and advanced until it passed through the distal portal. Then a 2.7 mm endoscope was passed into from the proximal portal and a retrograde knife was introduced into the operative site from the distal portal. Finally the entire length of sheath was sectioned under direct endoscopic vision. Results All operations were successfully completed. Finger's flexion and extension function recovered immediately after the operations. All the patients restarted their employment one week postoperatively. There were no complications such as distinct pain or delayed wound healing in these patients. Conclusions This method has the advantages of minimal invasion, safety, effectiveness and quick recovery, especially suited to diabetic patients or multiple trigger fingers.