Treatment of notta desease according to shastin method in our modification

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.