Hansjörg Wyss Department of Plastic and Reconstructive Surgery, New York University Langone Medical Center, USA.
Hansjörg Wyss Department of Plastic and Reconstructive Surgery, New York University Langone Medical Center, USA.
J Plast Reconstr Aesthet Surg. 2017 Jan;70(1):127-131. doi: 10.1016/j.bjps.2016.08.020. Epub 2016 Sep 9.
De Quervain syndrome or tenosynovitis is a common wrist pathology caused by stenosing tenosynovitis of the first dorsal compartment. Multiple studies have demonstrated significant anatomic variation within the first extensor compartment.
The terms "De Quervain's tenosynovitis" and "first extensor compartment anatomy" were comprehensively searched using the PubMed, MEDLINE, and Cochrane database. The presence of a septum within the first dorsal compartment, the number of APL (abductor pollicis longus), and EPB (extensor pollicis brevis) tendon slips were identified.
A total of 574 articles were identified on initial search, of which 21 met inclusion criteria. There were 1901 normal cadaver specimens and 470 surgically treated De Quervain disease patients, whose data were available. A septum was present in 43.7% of normal cadavers versus 62.2% De Quervain patients with 58.5% (327 of 559) of the septi characterized as incomplete. There was a difference in the number of APL tendons with a single APL tendon slip noted in 18.3% of normal cadavers (200/1096) versus 27.2% of De Quervain patients (87/230). There was a difference in the number of EPB tendons between the normal cadavers and De Quervain's wrists with 2 or more EPB tendinous slips observed in 5.9% of normal cadavers compared with 2.9% of De Quervain patients.
Significant anatomic variability exists within the first extensor compartment. Patients with De Quervain disease were more likely to have a septum dividing the compartment and a single slip of APL. These variations are clinically relevant in the pathophysiology and treatment of De Quervain's tenosynovitis.
Prognostic studies.
Level III.
德奎文氏综合征或腱鞘炎是一种常见的腕部疾病，由第一背侧间隔的狭窄性腱鞘炎引起。多项研究表明，第一伸肌间隔内存在明显的解剖变异。
使用 PubMed、MEDLINE 和 Cochrane 数据库全面搜索“德奎文氏腱鞘炎”和“第一伸肌间隔解剖”这两个术语。确定第一背侧间隔内是否存在隔膜、APL（拇长展肌）和 EPB（伸拇指短肌）肌腱滑液的数量。
初步搜索共确定了 574 篇文章，其中 21 篇符合纳入标准。共有 1901 例正常尸体标本和 470 例经手术治疗的德奎文氏病患者，其数据可用。在正常尸体中，隔膜的存在率为 43.7%，而德奎文氏病患者为 62.2%，其中 58.5%（327/559）的隔膜为不完全隔膜。APL 肌腱的数量存在差异，在正常尸体中，单根 APL 肌腱滑液的发生率为 18.3%（200/1096），而在德奎文氏病患者中为 27.2%（87/230）。正常尸体和德奎文氏手腕之间 EPB 肌腱的数量也存在差异，正常尸体中有 5.9%（20/339）有 2 根或更多的 EPB 肌腱滑液，而德奎文氏病患者中有 2.9%（7/230）。
第一伸肌间隔内存在显著的解剖变异。患有德奎文氏病的患者更有可能出现分隔间隔的隔膜和单一 APL 滑液。这些变异在德奎文氏腱鞘炎的病理生理学和治疗中具有临床意义。
预后研究。
三级。
