Schiedel F M, Langer M
Klinik und Poliklinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Münster.
Handchir Mikrochir Plast Chir. 2008 Jun;40(3):204-6. doi: 10.1055/s-2007-965736. Epub 2008 Jun 11.
The rare diagnosis of the Dieterich's disease at the head of the metacarpal III is presented on the case of a 19-year-old female patient. While aseptic bone necroses at the hand skeleton in handsurgical special departments are not rare and diagnostics and choice of the right treatment are not difficult, there are quite rare findings, which are not commonly known. Dieterich's disease finds precipitation in the literature in a handful of articles, mostly case reports. Dieterich saw among 8 patients 7 women, with a distribution of 7 concerned metacarpal bone III and one metacarpal bone IV. A preference of the female sex or the metacarpal bone III cannot be derived from it. Aseptic necroses at the hand are rarer than at the foot skeleton. Clinically, a swelling at the extensor side of the finger basic joint can exist with movement restriction, occasionally is the hand over it slightly turned red. Mechanical load aggravates the complaints. The clinical aspect, X-ray and therapy options are differentially presented and discussed with consideration of the specific literature.
本文报告了一例19岁女性患者,其第三掌骨头部罕见地诊断为迪特里希氏病。在手外科专科,手部骨骼的无菌性骨坏死并不罕见,诊断和选择正确的治疗方法也不难,但仍有一些罕见的发现并不为人们所熟知。迪特里希氏病在文献中仅有少数几篇文章提及,大多为病例报告。迪特里希观察的8例患者中有7例为女性,其中7例涉及第三掌骨,1例涉及第四掌骨。由此无法得出女性或第三掌骨更易患病的结论。手部的无菌性坏死比足部骨骼更为少见。临床上,手指近端关节伸侧可能出现肿胀并伴有活动受限,手部偶尔会稍发红。机械负荷会加重症状。结合具体文献,对其临床症状、X线表现及治疗方案进行了鉴别介绍和讨论。