Dumontier C, Chaumeil G, Chassat R, Nourissat G
Institut de la main, 6, square Jouvenet, 75016 Paris, France.
Chir Main. 2006 Nov;25S1:S214-S220. doi: 10.1016/j.main.2006.07.006. Epub 2006 Aug 4.
Incidentally discovered in 1987, arthroscopic treatment of dorsal wrist ganglia is based on our knowledge of their physiopathology which in turn benefits from the arthroscopic wrist evaluation. Dorsal wrist ganglia arise in the radiocarpal space from the dorsal part of the scapholunate ligament and migrate along the dorsal wrist capsule. According to their position above or under the dorsal intercarpal ligament, their cutaneous projection may vary. The basis of the arthroscopic treatment of wrist ganglia is, as with open surgery, the capsular resection in front of their origin. Arthroscopic resection is made either from dorsal radio-carpal or midcarpal approaches with little morbidity. Scars are unnoticeable, wrist mobility and strength close to normal by three months, which is the delay for dorsal wrist pain, always very limited, to disappear. The recurrence rate is however still debatable. Close to zero in some series, we had almost 20% recurrence rate in our series, with half of patients who reccur after two years follow-up. This variability in the recurrence rate also exists with open techniques. The only prospective and randomized study available to date found no differences between the two techniques, according to the recurrence rate.
腕背腱鞘囊肿于1987年偶然被发现，其关节镜治疗基于我们对其病理生理学的认识，而这又得益于关节镜下腕关节评估。腕背腱鞘囊肿起源于桡腕关节间隙内的舟月韧带背侧部分，并沿腕背关节囊迁移。根据其位于腕背间韧带上方或下方的位置，其皮肤投影可能会有所不同。与开放手术一样，腕腱鞘囊肿关节镜治疗的基础是在其起源前方进行关节囊切除。关节镜切除可通过桡腕背侧或腕中入路进行，并发症很少。疤痕不明显，三个月时腕关节活动度和力量接近正常，而腕背疼痛的持续时间通常非常有限，此时疼痛会消失。然而，复发率仍存在争议。在一些系列研究中接近零，但我们的系列研究中复发率近20%，其中一半患者在两年随访后复发。开放手术技术的复发率也存在这种变异性。迄今为止唯一一项前瞻性随机研究发现，根据复发率，两种技术之间没有差异。
