Owers K L, Lee J, Khan N, Healy J, Eckersley R
Department of Hand Surgery, Chelsea and Westminster Hospital NHS Trust, London, UK.
J Hand Surg Eur Vol. 2007 Aug;32(4):467-71. doi: 10.1016/J.JHSB.2006.11.021. Epub 2007 Jun 12.
Extensor pollicis longus tendon rupture occurs in 0.2% to 3% of fractures of the distal radius. The underlying mechanism, or mechanisms, of rupture are unknown. This study evaluated this tendon and its surrounding structures using high-resolution ultrasound in 62 patients with distal radius fracture at 6 weeks after injury. The uninjured wrist was examined as a control. The ultrasound measurements at 6 weeks were then correlated with the patients' presenting X-rays. Significant findings included a reduced peak velocity of tendon movement and an increased thickness of both the extensor retinaculum and the tendon sheath on the fractured side. In respect of tendon sheath thickness, these changes were particularly associated with intraarticular fractures. We postulate that the increased thickness of the EPL tendon sheath may further impair an already tenuous blood supply and/or affect the diffusion of nutrients to the tendon within the third extensor compartment, leading to tendon attrition and rupture.
拇长伸肌腱断裂发生于2%至3%的桡骨远端骨折患者中。其断裂的潜在机制尚不清楚。本研究对62例桡骨远端骨折患者在受伤6周后使用高分辨率超声评估了该肌腱及其周围结构。对未受伤的手腕进行检查作为对照。然后将6周时的超声测量结果与患者受伤时的X线片进行相关性分析。重要发现包括患侧肌腱运动峰值速度降低，伸肌支持带和腱鞘厚度增加。就腱鞘厚度而言，这些变化尤其与关节内骨折有关。我们推测，拇长伸肌腱腱鞘厚度增加可能会进一步损害本就脆弱的血供和/或影响营养物质向第三伸肌间隙内肌腱的扩散，导致肌腱磨损和断裂。
