Mahakkanukrauh P, Mahakkanukrauh C
Department of Anatomy, Faculty of Medicine, Chiangmai University, Chiangmai, Thailand.
Clin Anat. 2000;13(3):195-8. doi: 10.1002/(SICI)1098-2353(2000)13:3<195::AID-CA6>3.0.CO;2-V.
Because there has been no study of the presence of a septum in the first dorsal compartment of the wrist in Asians and there is no method of conservative treatment of de Quervain's disease based on the presence of this septum, the authors have evaluated this septum in a large Asian population. Two-hundred wrists in 100 Asian cadavers were dissected. The presence of the septum was documented by removing the abductor pollicis longus (APL) tendon from its tunnel in the first dorsal compartment and observing through the same tunnel if there was a septum to prevent immediate access to the extensor pollicis brevis (EPB) tendor. A septum was present in 77.5% of wrists. When the septum was present, the resultant subcompartment for the EPB was quite narrow. Given the high incidence of the septum, therapy of de Quervain's disease could reasonably be modified accordingly. For instance, to improve the success rate for local steroid injection, the solution of steroid should aim at reaching both subjcompartments by redirecting the course of the injecting needle. As for surgical release, adequacy could be enhanced by the realization by the surgeon of the possible presence of the septum.
由于此前尚无针对亚洲人腕部第一背侧间室中隔存在情况的研究，且不存在基于该中隔情况的桡骨茎突狭窄性腱鞘炎保守治疗方法，因此作者对大量亚洲人群中的该中隔进行了评估。解剖了100具亚洲尸体的200个腕部。通过将拇长展肌（APL）肌腱从其在第一背侧间室的腱鞘中取出，并通过同一腱鞘观察是否存在中隔以阻止直接触及拇短伸肌（EPB）肌腱，来记录中隔的存在情况。77.5%的腕部存在中隔。当中隔存在时，EPB形成的子间室相当狭窄。鉴于中隔的高发生率，桡骨茎突狭窄性腱鞘炎的治疗可据此合理调整。例如，为提高局部类固醇注射的成功率，类固醇溶液应通过改变注射针的进针路径，使其能够到达两个子间室。至于手术松解，外科医生意识到可能存在中隔可提高手术的充分性。
