Wide-awake ultrasound-guided percutaneous extensor central slip tenotomy for chronic mallet finger: A prospective study of 14 cases (with videos)
| Autor: | T. Apard, G. Candelier |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Percutaneous Visual Analog Scale medicine.medical_treatment Tenotomy 030230 surgery 03 medical and health sciences 0302 clinical medicine Mallet finger Tendon Injuries Finger Injuries Hand Deformities Acquired medicine Deformity Humans Orthopedics and Sports Medicine Local anesthesia Prospective Studies Swan neck deformity Ultrasonography Interventional Aged 030222 orthopedics Tourniquet business.industry Rehabilitation Middle Aged medicine.disease Surgery body regions Ambulatory Surgical Procedures Female medicine.symptom Interphalangeal Joint business Anesthesia Local |
| Zdroj: | Hand Surgery and Rehabilitation. 36:86-89 |
| ISSN: | 2468-1229 |
| DOI: | 10.1016/j.hansur.2016.12.006 |
| Popis: | The central slip tenotomy described by Fowler is an effective option for treating chronic mallet finger in order to avoid swan neck deformity of the finger. In a prospective study of 14 cases (13 failures of conservative treatment and one case of untreated mallet finger), we performed percutaneous ultrasound-guided central slip tenotomy with a 19 G needle using the wide-awake local anesthesia and no tourniquet (WALANT) technique. The mean extensor lag before surgery was 28° (range 20°–40°) and three patients had a swan neck deformity. The anesthesia and tenotomy were guided with a 15 MHz high frequency probe. Patient were asked to grade their pain between 0 (no pain) and 10 (extreme pain) with a Visual Analog Scale (VAS), to flex and extend their finger immediately after the tenotomy and to be reviewed at 1 month's follow-up. The mean pain score on VAS during the procedure was 1/10 (range 0–3). After several movements of the finger after the procedure, two patients immediately regained full extension of the distal interphalangeal joint. At 1 month follow-up, the correction was complete for 10 patients, three patients had a residual deformity of 10° and one had a poor result with a 30° deformity. Two patients had a persistent painless synovitis of the proximal interphalangeal joint. Thirteen patients were fully satisfied and one was a disappointed, but did not want another treatment. There are no published reports of percutaneous central slip tenotomy. In this preliminary report, central slip tenotomy for chronic mallet finger with ultrasonography was painless, effective and safe under WALANT technique. Larger clinical studies are needed to confirm the outcomes of this study. |
| Databáze: | OpenAIRE |
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