针刀治疗扳机指操作方法对手指掌侧面局部解剖结构损伤情况的研究

关键词：扳机指  解剖  针刀  疗法腱鞘炎

Keywords:trigger finger  anatomy  needle knife therapy  tenosynovitis

摘要：

      摘要 目的：解剖验证几种针刀治疗扳机指操作方法对手指掌侧面局部解剖结构的损伤情况的安全性，为针刀疗法安全应用提供解剖学依据。 方法：在6具尸体标本上，模拟常用的针刀治疗扳机指的几种常用操作方法，于操作后解剖标本并观察针刀对手指掌侧面局部解剖结构的影响损伤情况。 结果：这几种操作方法均可刺入或穿透指屈肌腱，更甚者，如将指屈肌腱从骨面上铲起，会伤及骨膜和腱系膜等结构。纵横疏拨有可能割伤，甚至切断指屈肌腱和指掌侧固有神经及血管。 结论：目前临床常用的几种针刀治疗扳机指的操作方法均可能伤及指屈肌腱，甚至可能伤及腱系膜、骨膜、指掌侧固有神经和血管，操作者应熟悉局部解剖并应慎重操作。

Abstract:

      Abstract Objective:To verify the injury on fingers caused by several kinds of operating processes of needle knife treatments on trigger finger, and to provide reliable anatomical basis for more reasonable use of needle knife therapy in clinic. Method: Several kinds of common used operating processes of needle knife treatments on trigger fingers were performed simulatedly to operate on 6 cadaveric specimens, which were dissected to observe after operation. Result: With these common used operating processes the needle knife could prick in and pass through the flexor tendon and might cause some injuries. When the knife was moved vertically and horizontally, the flexor tendon and proper palmar digital nerves and blood vessels were injured, even cut off. Shoveling the flexor tendon from the surface of a phalange with needle knife, the flexor tendon, mesotendon, and periosteum were also injured. Conclusion: The several kinds of common used operating processes of needle knife treatments above-mentioned for trigger fingers may cause damages on flexor tendon, proper palmar digital nerves and vessels, mesotendon and periosteum. The operator should be familiar the local anatomy and take care to avoid the damages during operating.