Alexander Randall D, Catalano Louis W, Barron O Alton, Glickel Steven Z
C.V. Starr Hand Surgery Center at St. Luke's/Roosevelt Hospital, New York, NY, USA.
J Hand Surg Am. 2002 Sep;27(5):813-6. doi: 10.1053/jhsu.2002.35309.
Isolation of the extensor pollicis brevis (EPB) tendon in a separate compartment has been reported to contribute to the pathogenesis of de Quervain's disease and affect the patient's response to nonsurgical treatment. The EPB entrapment test was developed to evaluate the patient with de Quervain's disease. The purpose of this study was to compare the results from this preoperative test with the anatomic findings at surgery in patients who failed nonsurgical treatment. One hundred seventy-eight patients who were treated for de Quervain's disease (200 wrists) were asked to compare the amount of pain elicited by firm resistance with thumb metacarpophalangeal joint extension with that from resistance to palmar abduction. Twenty-six wrists (13%) had surgical release after failure of nonsurgical treatment. Of those having surgery the proportion of wrists with a positive EPB entrapment test was significantly higher among those with 2 compartments (18 of 22) than among those with 1 compartment (0 of 4) (Fisher's exact test). In the surgical group the EPB entrapment test showed 81% sensitivity and 50% specificity in identifying wrists with a separate EPB compartment.
据报道，拇短伸肌（EPB）肌腱在一个独立的腱鞘内被分隔出来，这与桡骨茎突狭窄性腱鞘炎的发病机制有关，并影响患者对非手术治疗的反应。EPB卡压试验用于评估桡骨茎突狭窄性腱鞘炎患者。本研究的目的是比较该术前检查结果与非手术治疗失败患者手术时的解剖学发现。178例接受桡骨茎突狭窄性腱鞘炎治疗的患者（200腕）被要求比较拇指掌指关节伸展时的强力抵抗与掌侧外展时的抵抗所引起的疼痛程度。26腕（13%）在非手术治疗失败后接受了手术松解。在接受手术的患者中，EPB卡压试验阳性的腕部比例在有两个腱鞘的患者（22例中有18例）中显著高于有一个腱鞘的患者（4例中有0例）（Fisher精确检验）。在手术组中，EPB卡压试验在识别有独立EPB腱鞘的腕部时，敏感性为81%，特异性为50%。
