Small incision tendinolysis under local anesthesia for 949 cases of pediatric stenosing tenovaginitis of thumb_West China Medical Journal

Authors：

WANG Daoxi , LIU Lijun , YANG Xiaodong , YANG Panyi ,  JIANG Xin

Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

JIANG Xin, Email: jiangxin1975@126.com

Keywords：

Children; stenosing tenovaginitis of thumb; local anesthesia; minimally invasive surgery

DOI：

10.7507/1002-0179.202308196

Video：

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Objective To investigate the therapeutic effect of minimally invasive small incision surgery under local anesthesia for pediatric stenosing tenovaginitis of thumb. Methods A retrospective analysis was conducted on the medical records of children with stenosing tenovaginitis of thumb who received small incision tendinolysis under local anesthesia at West China Hospital of Sichuan University between January 2013 and August 2022, to evaluate and analyze the safety and effectiveness of the surgery. Results A total of 949 pediatric patients were included, with an average age of (3.23±1.92) years. The average duration of surgery was (7.0±2.5) minutes, and the average follow-up time was (3.91±5.32) months. All patients did not need to fast for solids and liquids before surgery, and were immediately discharged from the hospital after outpatient surgery. The family members of the patients were highly satisfied with the treatment process and postoperative recovery. All patients had no nerve or vascular damage, and the wound margin skin showed linear healing with mild scars that fused with palm prints. There were 825 cases (86.93%) of children with thumb function fully restored to normal, 113 cases (11.91%) with limited maximum dorsiflexion function of the thumb, and 11 cases (1.16%) with recurrent stiffness of the thumb metacarpophalangeal joint. Conclusion Small incision tendinolysis under local anesthesia is a safe and effective treatment for pediatric stenosing tenovaginitis of thumb, with high satisfaction among the patients’ family members.

Citation： WANG Daoxi, LIU Lijun, YANG Xiaodong, YANG Panyi, JIANG Xin. Small incision tendinolysis under local anesthesia for 949 cases of pediatric stenosing tenovaginitis of thumb. West China Medical Journal, 2025, 40(4): 568-571. doi: 10.7507/1002-0179.202308196 Copy

1.	孫寧, 鄭珊, 馮杰雄, 等. 小兒外科學. 北京: 人民衛生出版社, 2015: 311-313.
2.	吳煌超, 孫勁, 張忠文. 指屈肌腱狹窄性腱鞘炎治療的研究進展. 中國醫藥導報, 2024, 21(1): 68-71.
3.	Choi S, Lim H, Ha C, et al. Prevalence and characteristics by age and sex in pediatric trigger digits: nationwide analysis using Korea health insurance dataset. Clin Orthop Surg, 2024, 16(4): 650-660.
4.	Hudock NL, Girgis MW, Glaun GD, et al. Paediatric trigger thumb: diagnostic pearls. J Paediatr Child Health, 2024, 60(11): 680-683.
5.	Lin JS, Pettit R, Rosenbaum JA, et al. The development of trigger thumb in the contralateral thumb in pediatric patients presenting initially with unilateral involvement. Hand (N Y), 2021, 16(3): 316-320.
6.	Venkatadass K, Bhardwaj P, Sabapathy SR. Pediatric trigger thumb: congenital or developmental? A unique case report. J Hand Microsurg, 2020, 12(Suppl 1): S75-S77.
7.	楊曉顏, 杜青, 周璇, 等. 中西醫結合治療小兒拇指扳機指的臨床療效. 教育生物學雜志, 2022, 10(2): 93-97.
8.	陳柏華, 羅軍, 熊祎玭, 等. 超聲引導下扳機指針刀松解的臨床價值. 中國超聲醫學雜志, 2021, 37(4): 456-459.
9.	Swanson AB, Hagert CG, Swanson GD. Evaluation of impairment of hand function. J Hand Surg Am, 1983, 8(5): 709-722.
10.	蔣良福, 周飛亞, 李志杰, 等. 兒童拇指扳機指局部封閉治療的療效分析. 中華手外科雜志, 2010, 26(6): 332-334.
11.	Wolfe SW, Hotchkiss RN, Pederson WC, et al. Green’s operative hand surgery. 7th ed. Philadelphia PA: Elsevier, 2017: 1320-1322.
12.	李偉笠, 劉方娜, 李振威, 等. 腱鞘松解術治療兒童扳機指 487 例療效分析. 河南外科學雜志, 2022, 28(2): 65-67.
13.	羅濤, 劉景. 微創松解療法治療指屈肌腱狹窄性腱鞘炎研究. 中國骨傷, 2013, 26(5): 438-440.
14.	屈亮, 胡迪, 吳夏勃, 等. 鉤刀松解法治療屈指肌腱狹窄性腱鞘炎的病例對照研究. 中國骨傷, 2010, 23(12): 942-944.
15.	李春葉, 張倩, 王華, 等. 超聲引導下不同型號針刀聯合復方倍他米松注射液治療扳機指的療效對比. 江蘇大學學報(醫學版), 2024, 34(3): 248-253.
16.	張良. 局麻藥物丁卡因與利多卡因在鼻內鏡中的療效比較. 繼續醫學教育, 2016, 30(4): 152-155.
17.	Wang B, Qi R, Gu J, et al. Efficacy analysis of three kinds of surgery for trigger thumb. Int Orthop, 2022, 46(12): 2853-2857.
18.	Edwards DS, Richards RH. Risk stratification for the recurrence of trigger thumb after surgical release in the paediatric patient. Eur J Orthop Surg Traumatol, 2016, 26(6): 587-590.
19.	Fiorini HJ, Tamaoki MJ, Lenza M, et al. Surgery for trigger finger. Cochrane Database Syst Rev, 2018, 2(2): CD009860.
20.	Shah AS, Bae DS. Management of pediatric trigger thumb and trigger finger. J Am Acad Orthop Surg, 2012, 20(4): 206-213.

1. 孫寧, 鄭珊, 馮杰雄, 等. 小兒外科學. 北京: 人民衛生出版社, 2015: 311-313.
2. 吳煌超, 孫勁, 張忠文. 指屈肌腱狹窄性腱鞘炎治療的研究進展. 中國醫藥導報, 2024, 21(1): 68-71.
3. Choi S, Lim H, Ha C, et al. Prevalence and characteristics by age and sex in pediatric trigger digits: nationwide analysis using Korea health insurance dataset. Clin Orthop Surg, 2024, 16(4): 650-660.
4. Hudock NL, Girgis MW, Glaun GD, et al. Paediatric trigger thumb: diagnostic pearls. J Paediatr Child Health, 2024, 60(11): 680-683.
5. Lin JS, Pettit R, Rosenbaum JA, et al. The development of trigger thumb in the contralateral thumb in pediatric patients presenting initially with unilateral involvement. Hand (N Y), 2021, 16(3): 316-320.
6. Venkatadass K, Bhardwaj P, Sabapathy SR. Pediatric trigger thumb: congenital or developmental? A unique case report. J Hand Microsurg, 2020, 12(Suppl 1): S75-S77.
7. 楊曉顏, 杜青, 周璇, 等. 中西醫結合治療小兒拇指扳機指的臨床療效. 教育生物學雜志, 2022, 10(2): 93-97.
8. 陳柏華, 羅軍, 熊祎玭, 等. 超聲引導下扳機指針刀松解的臨床價值. 中國超聲醫學雜志, 2021, 37(4): 456-459.
9. Swanson AB, Hagert CG, Swanson GD. Evaluation of impairment of hand function. J Hand Surg Am, 1983, 8(5): 709-722.
10. 蔣良福, 周飛亞, 李志杰, 等. 兒童拇指扳機指局部封閉治療的療效分析. 中華手外科雜志, 2010, 26(6): 332-334.
11. Wolfe SW, Hotchkiss RN, Pederson WC, et al. Green’s operative hand surgery. 7th ed. Philadelphia PA: Elsevier, 2017: 1320-1322.
12. 李偉笠, 劉方娜, 李振威, 等. 腱鞘松解術治療兒童扳機指 487 例療效分析. 河南外科學雜志, 2022, 28(2): 65-67.
13. 羅濤, 劉景. 微創松解療法治療指屈肌腱狹窄性腱鞘炎研究. 中國骨傷, 2013, 26(5): 438-440.
14. 屈亮, 胡迪, 吳夏勃, 等. 鉤刀松解法治療屈指肌腱狹窄性腱鞘炎的病例對照研究. 中國骨傷, 2010, 23(12): 942-944.
15. 李春葉, 張倩, 王華, 等. 超聲引導下不同型號針刀聯合復方倍他米松注射液治療扳機指的療效對比. 江蘇大學學報(醫學版), 2024, 34(3): 248-253.
16. 張良. 局麻藥物丁卡因與利多卡因在鼻內鏡中的療效比較. 繼續醫學教育, 2016, 30(4): 152-155.
17. Wang B, Qi R, Gu J, et al. Efficacy analysis of three kinds of surgery for trigger thumb. Int Orthop, 2022, 46(12): 2853-2857.
18. Edwards DS, Richards RH. Risk stratification for the recurrence of trigger thumb after surgical release in the paediatric patient. Eur J Orthop Surg Traumatol, 2016, 26(6): 587-590.
19. Fiorini HJ, Tamaoki MJ, Lenza M, et al. Surgery for trigger finger. Cochrane Database Syst Rev, 2018, 2(2): CD009860.
20. Shah AS, Bae DS. Management of pediatric trigger thumb and trigger finger. J Am Acad Orthop Surg, 2012, 20(4): 206-213.

West China Medical Journal

Small incision tendinolysis under local anesthesia for 949 cases of pediatric stenosing tenovaginitis of thumb

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