■狭窄的屈肌腱腱鞘炎通常通过将皮质类固醇注射到屈肌腱鞘中来治疗。然而,文献中关于最优技术没有共识,特别是当不使用超声引导。这里,我们提出了一项尸体研究,其中比较了3种常用的屈肌鞘注射技术的准确性和安全性.
■将15只新鲜冷冻的尸体手(60位数)平均分为3组(每组20位数)。使用3种技术中的1种(掌骨,掌上肌腱,和中轴)。然后解剖手指并检查染料的位置,以及肌腱或数字神经的损伤。
■中轴技术以所有鞘内注射的最高速率显示出最大的准确性,20位数字中的15位(75%),虽然掌骨技术产生了最多的联合鞘内和鞘外注射,20位数字中的13位,(65%)和掌上肌腱技术导致了最多的鞘外注射,20位数字中的9位(45%)。所有鞘内注射率差异显著(P=0.01)。中轴技术也产生了最少的肌腱内注射20次中的0次,尽管该结果没有达到统计学意义(P=.15)。
■与其他常见的非图像引导的屈肌腱鞘注射技术相比,发现中轴注射技术在进行所有鞘内注射时最准确,并且最不可能导致肌腱内注射。
UNASSIGNED: Stenosing flexor tenosynovitis is commonly treated by injection of corticosteroids into the flexor tendon sheath. However, there is no consensus in the literature regarding the optimal technique, specifically when not utilizing ultrasound guidance. Here, we present a cadaver
study in which 3 common techniques of flexor sheath injection were compared with regard to their accuracy and safety profiles.
UNASSIGNED: Fifteen fresh-frozen cadaver hands (60
digits) were evenly divided into 3 groups (20
digits per group).
Digits in each group were injected with methylene blue dye using 1 of the 3 techniques (palmar-to-bone, palmar supra-tendinous, and mid-axial). The fingers were then dissected and were inspected for location of dye, as well as injury to tendon or digital nerves.
UNASSIGNED: The mid-axial technique demonstrated the greatest accuracy with the highest rate of all intra-sheath injection, 15 of 20 digits (75%), while the palmar-to-bone technique produced the most combined intra- and extra-sheath injections, 13 of 20 digits, (65%) and the palmar supra-tendinous technique resulted in the most all extra-sheath injections, 9 of 20
digits (45%). The difference in rates of all intra-sheath injection was significant (P = .01). The mid-axial technique also produced the fewest intra-tendinous injections 0 of 20, although this result did not reach statistical significance (P = .15).
UNASSIGNED: Compared to other common non-image guided flexor tendon sheath injection techniques, the mid-axial injection technique was found to be the most accurate in producing all intra-sheath injection and least likely to result in intra-tendinous injection.