Abstract:
Tenosynovitis stenosans is a dysplastic pathology of the anular ligament of the fingers that occurs in children
most often between the ages of 1 to 3 years. The anular ligaments of the first finger are most often affected,
although this is possible with the other fingers. Parents notice the difficult extension of the first finger or the
inability to unbend the first finger completely. Also one can notice directly at the base of the first finger on the
palmar side a thickening.
The purpose is to prove the effectiveness of the mini-invasive method of treatment according to Shastin
method in our modification.
In recent years, we observed 67 children under the age of 3 years, in 51 cases the constrictive ligament was
observed in the first finger, 16 were from other fingers. In 49 cases it was on both first fingers of brushes. Before
surgery, ultrasound was also performed, which specified the area of the pathologically altered anular ligament
and its extent. Operative access is performed on the palmar surface in the middle of the finger through a point
incision (according to Shastin method) with a special pointed scalpel in the projection of the pathologically altered anular ligament, which was later dissected longitudinally. After all procedures a tendon of the long flexor
gets the possibility of free sliding in its channel and the finger takes the usual position. The edges of the surgical
wound approached by a thin strip of adhesive. After getting out of anesthetic sleep the child could move his
finger freely. Traced long-term results up to 7 years in 45 patients. The functions of the fingers were restored
completely in all 45 patients, there were no relapses.
Operative treatment in our modification is low-traumatic, highly effective and extremely rarely leads to
relapses.
