• 廣州中醫(yī)藥大學(xué)第二臨床醫(yī)學(xué)院 廣東省中醫(yī)院芳村骨科（廣州，510370）;

【摘 要】 目的 探討經(jīng)皮微創(chuàng)空心L形針刀治療彈響指的療效。 方法 2007年9月－2009年9月，采用自行設(shè)計(jì)的空心L形針刀微創(chuàng)治療160例（202指）彈響指。男47例，女113例；年齡12～68歲，平均55歲。病程2周～1年。拇指58指，示指20指，中指46指，環(huán)指60指，小指18指。根據(jù)Quinnell分級(jí)標(biāo)準(zhǔn)：Ⅲ級(jí)63指，Ⅳ級(jí)126指，Ⅴ級(jí)13指。術(shù)中首先用空心L形針刀自皮下潛行至A1滑車部遠(yuǎn)端，向遠(yuǎn)端平行縱向切割后，自針刀空心向腱鞘部注入倍他米松。 結(jié)果 患者手術(shù)時(shí)間5～19 min，平均8.2 min；無手術(shù)相關(guān)并發(fā)癥發(fā)生。160例均獲隨訪，隨訪時(shí)間1年～3年6個(gè)月，平均1.6年。術(shù)后1周36指手術(shù)松解處疼痛，口服非甾體類消炎藥后緩解。術(shù)后1周25指屈伸活動(dòng)時(shí)仍存在扳機(jī)樣感及頓挫感，1個(gè)月后5指恢復(fù)正常，20指癥狀無明顯改善；其中10指再次行針刀治療后癥狀緩解，余10指經(jīng)1～3次針刀治療后無緩解。術(shù)后6個(gè)月參照Quinnell分級(jí)標(biāo)準(zhǔn)評(píng)定療效：獲優(yōu)165指，良27指，差10指，優(yōu)良率為95.0%。 結(jié)論 經(jīng)皮微創(chuàng)空心L形針刀治療彈響指安全有效、易于操作。

引用本文： 王慧敏,曾浩彬,伍翰笙,沈慶亮,蔡材樑,陳文治,吳漢卿. 經(jīng)皮微創(chuàng)空心L形針刀治療彈響指. 中國(guó)修復(fù)重建外科雜志, 2012, 26(1): 14-16. doi: 復(fù)制

1. the ‘life-cut’ technique. Br J Plast Surg, 2005, 58(3): 817-821.
2. technique. J Hand Surg (Br), 2004, 29(5): 502-505.
3. surgery for trigger thumb in Children. Plast Reconstr Surg, 2005, 115(7): 1963-1970.
4. Clapham PJ, Chung KC. A historical perspective of the Notta’s node in trigger fingers. J Hand Surg (Am), 2009, 34(8): 1518-1522.
5. Maneerit J, Sriworakun C, Budhraja N, et al. Trigger thumb: results of a prospective randomised study of precutaneous release with steroid injection versus steroid injection alone. J Hand Surg (Br), 2003, 28(6): 586-589.
6. Ragoowansi R, Acornley A, Khoo CT. Percutaneous trigger finger release:.
7. Miyamoto H, Miura T, Isayama H, et al. Stiffness of the first annular pulley in normal and trigger fingers. J Hand Surg (Am), 2011, 36(9): 1486-1491.
8. Lee WT, Chong AK. Outcome study of open trigger digit release. J Hand Surg Eur Vol, 2011, 36(4): 339.
9. Marek DJ, Fitoussi F, Bohn DC, et al. Surgical release of the pediatric trigger thumb. J Hand Surg (Am), 2011, 36(4): 647-652. e2.
10. Park MJ, Oh I, Ha KI. A1 pulley release of locked trigger digit by percutaneous.
11. Pope DF, Wolfe SW. Safety and efficacy of precutaneous trigger finger release. J Hand Surg (Am), 1995, 20(2): 280-283.
12. Wilhelmi BJ, Snyder N 4th, Verbesey JF, et al. Trigger finger release with hand surface landmark ratios: an anatomic and clinical study. Plast Reconstr Surg, 2001, 108(4): 908-915.
13. Hazani R, Engineer NJ, Zeineh LL, et al. Assessment of the distal extent of the A1 pulley release: a new technique. Eplasty, 2008, 8: e44.
14. Lorthioir J Jr. Surgical treatment of trigger finger by a subcutaneous method. J Bone Joint Surg (Am), 1958, 40-A(4): 793-795.
15. Wang HC, Lin GT. Retrospective study of open versus precutaneous.
  1. 1. the ‘life-cut’ technique. Br J Plast Surg, 2005, 58(3): 817-821.
  2. 2. technique. J Hand Surg (Br), 2004, 29(5): 502-505.
  3. 3. surgery for trigger thumb in Children. Plast Reconstr Surg, 2005, 115(7): 1963-1970.
  4. 4. Clapham PJ, Chung KC. A historical perspective of the Notta’s node in trigger fingers. J Hand Surg (Am), 2009, 34(8): 1518-1522.
  5. 5. Maneerit J, Sriworakun C, Budhraja N, et al. Trigger thumb: results of a prospective randomised study of precutaneous release with steroid injection versus steroid injection alone. J Hand Surg (Br), 2003, 28(6): 586-589.
  6. 6. Ragoowansi R, Acornley A, Khoo CT. Percutaneous trigger finger release:.
  7. 7. Miyamoto H, Miura T, Isayama H, et al. Stiffness of the first annular pulley in normal and trigger fingers. J Hand Surg (Am), 2011, 36(9): 1486-1491.
  8. 8. Lee WT, Chong AK. Outcome study of open trigger digit release. J Hand Surg Eur Vol, 2011, 36(4): 339.
  9. 9. Marek DJ, Fitoussi F, Bohn DC, et al. Surgical release of the pediatric trigger thumb. J Hand Surg (Am), 2011, 36(4): 647-652. e2.
  10. 10. Park MJ, Oh I, Ha KI. A1 pulley release of locked trigger digit by percutaneous.
  11. 11. Pope DF, Wolfe SW. Safety and efficacy of precutaneous trigger finger release. J Hand Surg (Am), 1995, 20(2): 280-283.
  12. 12. Wilhelmi BJ, Snyder N 4th, Verbesey JF, et al. Trigger finger release with hand surface landmark ratios: an anatomic and clinical study. Plast Reconstr Surg, 2001, 108(4): 908-915.
  13. 13. Hazani R, Engineer NJ, Zeineh LL, et al. Assessment of the distal extent of the A1 pulley release: a new technique. Eplasty, 2008, 8: e44.
  14. 14. Lorthioir J Jr. Surgical treatment of trigger finger by a subcutaneous method. J Bone Joint Surg (Am), 1958, 40-A(4): 793-795.
  15. 15. Wang HC, Lin GT. Retrospective study of open versus precutaneous.