Thwin San San, Fazlin Fazlin, Than Myo
Anatomy Department, Universiti Kuala Lumpur - Royal College of Medicine Perak, 3 Jalan Greentown, 30450 Ipoh, Perak, Malaysia.
Singapore Med J. 2014 Jan;55(1):37-40. doi: 10.11622/smedj.2013216.
Multiple tendons of the abductor pollicis longus (APL) in the anatomical snuffbox of the wrist can lead to the development of de Quervain's syndrome, which is caused by stenosing tenosynovitis. A cadaveric study was performed to establish the variations present in the tendons of the anatomical snuffbox in a Malaysian population, in the hope that this knowledge would aid clinical investigation and surgical treatment of de Quervain's tenosynovitis.
Routine dissection of ten upper limbs was performed to determine the variations in the tendons of the anatomical snuffbox of the wrist.
In all the dissected upper limbs, the APL tendon of the first extensor compartment was found to have several (3-14) tendon slips. The insertion of the APL tendon slips in all upper limbs were at the base of the first metacarpal bone, trapezium and fascia of the opponens pollicis muscle; however, in seven specimens, they were also found to be attached to the fleshy belly of the abductor pollicis brevis muscle. In two specimens, double tendons of the extensor pollicis longus located in the third extensor compartment were inserted into the capsule of the proximal interphalangeal joints before being joined to the extensor expansion. In two other specimens, the first extensor compartment had two osseofibrous tunnels divided by a septum that separated the APL tendon from the extensor pollicis brevis tendon.
Multiple variations were found in the anatomical snuffbox region of the dissected upper limbs. Knowledge of these variations would be useful in interventional radiology and orthopaedic surgery.
腕部解剖鼻烟壶内的拇长展肌（APL）多肌腱可导致桡骨茎突狭窄性腱鞘炎，即de Quervain综合征。进行了一项尸体研究，以确定马来西亚人群腕部解剖鼻烟壶肌腱的变异情况，希望这些知识有助于de Quervain腱鞘炎的临床研究和手术治疗。
对10条上肢进行常规解剖，以确定腕部解剖鼻烟壶肌腱的变异情况。
在所有解剖的上肢中，发现第一伸肌间隔的APL肌腱有几条（3 - 14条）肌腱束。所有上肢中APL肌腱束的附着点均在第一掌骨基部、大多角骨和拇对掌肌筋膜处；然而，在7个标本中，还发现它们附着于拇短展肌的肌腹。在2个标本中，位于第三伸肌间隔的拇长伸肌双肌腱在与伸肌扩张部相连之前插入近节指间关节囊。在另外2个标本中，第一伸肌间隔有两个骨纤维隧道，由一个间隔分隔，该间隔将APL肌腱与拇短伸肌腱分开。
在解剖的上肢的解剖鼻烟壶区域发现了多种变异。了解这些变异对介入放射学和骨科手术有用。
