Eiken O, Haga T, Sälgeback S
Scand J Plast Reconstr Surg. 1976;10(1):59-63.
Rheumatoid involvement on the flexor aspect of the hand is common, but is easily overlooked because of difficulty in clinical examination. It is our experience that this localization of the disease process is extremely important and that surgical treatment should be given high priority. In this study a series of 235 operations on the flexor aspect of the hand performed on 139 patients are presented. The results are very gratifying as far as tenosynovectomy in the carpal tunnel and the pain is concerned. When performed on the fingers, however, varying degrees of postoperative flexion contractures developed in no less than 44%. It was found that this problem arose when the synovectomy was extended beyond the level of the middle flexion crease of the finger being caused by excessive postoperative scar formation in the region volar to the proximal interphalangeal joint between the tails of the superficial tendon. It is concluded that less extensive surgery should be aimed at in this particular area.
类风湿性关节炎累及手部屈侧很常见，但由于临床检查困难，很容易被忽视。我们的经验是，这种疾病进程的定位极其重要，手术治疗应给予高度重视。在本研究中，我们介绍了对139例患者的手部屈侧进行的一系列235次手术。就腕管内的腱鞘炎和疼痛而言，结果非常令人满意。然而，当手术在手指上进行时，不少于44%的患者出现了不同程度的术后屈曲挛缩。结果发现，当滑膜切除术延伸到手指中间屈曲横纹以下时，就会出现这个问题，这是由近端指间关节掌侧浅肌腱尾部之间区域术后过度瘢痕形成所致。得出的结论是，在这个特定区域应进行范围较小的手术。
