Witt J, Pess G, Gelberman R H
Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, 02114.
J Bone Joint Surg Am. 1991 Feb;73(2):219-22.
In a prospective study of non-operative treatment of de Quervain tenosynovitis, ninety-nine wrists of ninety-five consecutively seen patients who had this diagnosis had an injection of one milliliter of a 1 per cent lidocaine solution and one milliliter of a suspension containing forty milligrams of methylprednisolone acetate. Twelve patients (twelve wrists) were lost to follow-up. Of the remaining eighty-seven wrists, fifty-four (62 per cent) had a satisfactory outcome at a mean of eighteen months (minimum follow-up, twelve months). The duration of symptoms before treatment did not affect the outcome. The result in thirty-three wrists (38 per cent) was considered unsatisfactory. Thirty of these wrists were subsequently treated with operative release of the first dorsal compartment, and twenty-two (73 per cent) of the thirty were found to have a separate compartment for the extensor pollicis brevis. The prevalence of a separate compartment is significantly higher than that in the general population, as shown in anatomical studies of cadavera.
在一项关于桡骨茎突狭窄性腱鞘炎非手术治疗的前瞻性研究中，95例连续就诊且确诊为此病的患者共99个腕关节接受了1毫升1%利多卡因溶液和1毫升含40毫克醋酸甲基泼尼松龙混悬液的注射治疗。12例患者（12个腕关节）失访。在其余87个腕关节中，54个（62%）在平均18个月（最短随访12个月）时获得了满意的结果。治疗前症状持续时间不影响治疗结果。33个腕关节（38%）的结果被认为不满意。其中30个腕关节随后接受了第一背侧腱鞘切开减压术治疗，30个中有22个（73%）发现拇短伸肌有一个独立的腱鞘。如尸体解剖学研究所示，独立腱鞘的发生率显著高于普通人群。
