Shiraishi Naoki, Matsumura George
Department of Anatomy, School of Medicine, Kyorin University, Shinkawa 6-20-2, Mitaka City, Tokyo 181-8611.
Okajimas Folia Anat Jpn. 2005 May;82(1):25-9. doi: 10.2535/ofaj.82.25.
Sufficient improvement in De Quervain disease, is not always archieved even by tenosynovectomy, and the reason for this appears to be anatomical variation in the first extensor compartment of the hand. In this study we examined the first extensor compartment of 159 hands of 80 human cadavers. Hiranuma and colleagues documented four anatomical types of first compartment, and in this study type A was observed in 76 (47.8%) of the 159 hands, type B in 49 (30.8%), and type C in 21 (13.2%). No type D compartments in which the extensor pollicis brevis tendon is absent, were observed. There were 13 hands that did not fit any of Hiranuma's categories, and we classified them into three new types: E, F, and G. The numbers of extensor pollicis brevis tendons in the first compartment varied from one to three, and the number of abductor pollicis longus tendons varied from one to seven. Successful tenosynovectomy in the treatment of De Quervain disease requires to pay close attention to accessory tendons of the extensor pollicis brevis tendon and abductor pollicis longus tendon, branching of the tendons, and the presence of an atypical septum in the first compartment.
即使进行腱鞘切除术，桡骨茎突狭窄性腱鞘炎也并非总能获得充分改善，其原因似乎是手部第一伸肌间隔存在解剖变异。在本研究中，我们检查了80具人类尸体的159只手的第一伸肌间隔。Hiranuma及其同事记录了第一间隔的四种解剖类型，在本研究中，159只手中有76只（47.8%）观察到A型，49只（30.8%）为B型，21只（13.2%）为C型。未观察到拇短伸肌腱缺失的D型间隔。有13只手不符合Hiranuma的任何分类，我们将它们分为三种新类型：E型、F型和G型。第一间隔内拇短伸肌腱的数量从1条到3条不等，拇长展肌腱的数量从1条到7条不等。成功进行腱鞘切除术治疗桡骨茎突狭窄性腱鞘炎需要密切关注拇短伸肌腱和拇长展肌腱的副腱、肌腱分支以及第一间隔中是否存在非典型间隔。
