Ruchelsman David E, Vitale Mark A
Division of Hand Surgery, Newton-Wellesley Hospital, Department of Orthopaedic Surgery, Tufts University School of Medicine, Hand Surgery Research and Education Foundation, Newton, MA.
Orthopaedic & Neurosurgery Specialists, ONS Foundation for Clinical Research and Education, Greenwich, CT.
J Hand Surg Am. 2016 Nov;41(11):e433-e439. doi: 10.1016/j.jhsa.2016.08.009. Epub 2016 Sep 18.
Acute extensor carpi ulnaris (ECU) subsheath injury and chronic subsheath insufficiency may result in symptomatic ECU instability at the level of the distal ulna osseous sulcus. Associated ulnocarpal (ie, triangular fibrocartilage complex) and ECU intrinsic tendinopathic changes may accompany subsheath pathologies and require concomitant treatment. Surgical treatment is indicated in refractory cases despite nonoperative treatment and may consist of repair of the torn edge of the ECU subsheath or, more frequently, reconstruction utilizing a radially based extensor retinacular sling. An ECU subsheath reconstructive technique is detailed.
急性尺侧腕伸肌(ECU)腱鞘损伤和慢性腱鞘功能不全可能导致尺骨远端骨沟水平的症状性ECU不稳定。相关的尺腕(即三角纤维软骨复合体)和ECU内在肌腱病变可能伴随腱鞘病变,需要同时治疗。尽管进行了非手术治疗,但难治性病例仍需手术治疗,手术方式可能包括修复ECU腱鞘的撕裂边缘,或更常见的是使用桡侧伸肌支持带进行重建。本文详细介绍了一种ECU腱鞘重建技术。