屈指肌腱腱鞘炎：纵切口与横切口手术治疗的临床疗效
De qeurvian tenosynovitis: clinical outcomes of surgical treatment with longitudinal and transverse incision.
作者信息
Abrisham Syyed Jalil, Karbasi Mohammad Hosein Akhavan, Zare Jalil, Behnamfar Zahra, Tafti Arefah Dehghani, Shishesaz Behzad
出版信息
Oman Med J. 2011 Mar;26(2):91-3. doi: 10.5001/omj.2011.23.
OBJECTIVES
De Quervain disease is a mechanical tenosynovitis due to inadequacy volume between abductor pollicis longus, extensor pollicis brevis and their tunnel. Treatment methods include immobilization, steroid injections, and operation. For the first time Fritz De Quervain described surgical treatment of this disease. Since then, various ways of treatment have been reported. The purpose of this study is to compare the clinical outcomes of a longitudinal incision with a transverse incision in De Quervain disease.
METHODS
This was a randomized controlled clinical trial conducted in three hospitals in Iran, Yazd from March 2003 to September 2008. One hundred-twenty patients with De Quervain disease who did not respond to conservative treatment were operated with two different incisions. The patients were followed for three months to compare the surgical outcomes.
RESULTS
During a three month follow-up, a significant difference was shown between the two methods (p=0.03). Results of surgical treatment with longitudinal incision were excellent (only 5 hypertrophic scars), but there were 13 postoperative complaints with transverse incision.
CONCLUSION
According to our findings, longitudinal incision in surgical treatment of De Quervain disease is better than transverse incision.
目的
桡骨茎突狭窄性腱鞘炎是一种由于拇长展肌、拇短伸肌及其腱鞘之间容积不足引起的机械性腱鞘炎。治疗方法包括制动、类固醇注射和手术。弗里茨·德·奎尔万首次描述了该疾病的手术治疗方法。从那时起，已报道了各种治疗方法。本研究的目的是比较桡骨茎突狭窄性腱鞘炎纵向切口与横向切口的临床疗效。
方法
这是一项于2003年3月至2008年9月在伊朗亚兹德的三家医院进行的随机对照临床试验。120例对保守治疗无反应的桡骨茎突狭窄性腱鞘炎患者接受了两种不同切口的手术。对患者进行了三个月的随访以比较手术效果。
结果
在三个月的随访期间，两种方法之间存在显著差异（p=0.03）。纵向切口手术治疗的结果极佳（仅5例增生性瘢痕），但横向切口术后有13例出现不适。
结论
根据我们的研究结果，桡骨茎突狭窄性腱鞘炎手术治疗中纵向切口优于横向切口。
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