Clinical Anatomy Study On Arthroscopic Minimally Invasive Treatment Of Stenosis Tenosynovitis Of Flexor Digitorum Tendon

Objective In order to reduce the risk of injury volar anatomy,our study explores the surgical approach,standardizes the arthroscopic surgery operation process through studying the digital flexor tendon surrounding anatomical features.The study is designed to provide the anatomical basis and rationale for minimally invasive,precise arthroscopic operation.Methods Palmar anatomical data were measured from 11 fresh human cadavers.A simulated operation was conducted after the design of the surgical method.After the operation,a local anatomical study and anatomic measurement was conducted.The effectiveness and safety of this surgical method were evaluated,and the patients were selected for clinical application.Results 1.Surgical approach: The approach points for arthroscopic release of A1 trochlea of the index,middle,ring and little fingers were located at the intersection point of the transverse lines of the distal palmar and the median lines of the flexor tendons of each finger,and the cannula outlet was located at the transverse lines of the proximal finger.The entry point of thumb arthroscopic release of A1 pulley surgery was located 5mm at the proximal transverse striation of the thumb,and the exit was at the midpoint of the longitudinal axis of the proximal segment of the thumb.The operating diameter line was the longitudinal axis of flexor digitorum tendon,and the operating plane was the upper surface of flexor digitorum tendon.The distance between the four-finger approach point and the A1 pulley is sufficient to expose the tendon sheath and A1 pulley,which can provide a good endoscopic view.2.The A1 pulley can be dissected and released by simulated operation under arthroscope with matching tools 3.Local anatomy of the operative area confirmed the effect of A1 trochlear incision and release under arthroscopy,and no adjacent structural damage was observed.Anatomical measurements showed that there was a safe distance between the operating diameter line and the accompanying nerves and blood vessels.4.Two patients were treated with minimally invasive arthroscopy,and the treatment effect was satisfactory during the three-month follow-up after surgery.Conclusion Minimally invasive treatment of flexor digitor tendon stenosis tenosynovitis under arthroscopy is satisfied,with the advantages of safe visual,small trauma and quick recovery,and has considerable clinical application value.