Sugiura Shiro, Matsuura Yusuke, Kuniyoshi Kazuki, Nishikawa Satoru, Toyooka Takeshi, Mori Chisato, Suzuki Takane
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, 260-8670, Japan.
Nishikawa Orthopaedic Clinic, Chiba, Japan.
Surg Radiol Anat. 2017 Nov;39(11):1223-1226. doi: 10.1007/s00276-017-1867-2. Epub 2017 May 8.
The extensor pollicis brevis (EPB) tendon normally inserts into the base of the proximal phalanx of the thumb. However, a distal insertion of the EPB tendon into the thumb interphalangeal joint has been reported in refractory cases of de Quervain's disease. We hypothesized that the EPB tendon is wider beyond the thumb metacarpophalangeal joint in patients with extended EPB. This study aimed to evaluate the relationship between the extensor tendon width and the point of distal insertion of the EPB tendon.
In 45 hands from 18 male and 27 female adult cadavers, the first extensor compartment was dissected and the existence of the intertendinous septum was assessed. The extensor tendon width was measured at the midpoint of the proximal phalanx, and relationships between extended EPB tendon, existence rate of the intertendinous septum, sex, and extensor tendon width were examined.
Of 45 cases, intertendinous septum and extended EPB tendon were observed in 37 (82.2%) and 23 (51.1%), respectively. There was no significant difference between the existence rates of both these factors and sex. The mean extensor tendon width in the extended EPB group was significantly greater than in the normal EPB group. The cut-off value of extensor tendon width in the extended EPB group was 7.12 mm.
The extensor tendon width was wider in the extended EPB group than in the normal EPB group, suggesting that the differences in the EPB tendon width can be used to identify various anatomical variations in extended EPB.
拇短伸肌（EPB）肌腱通常插入拇指近节指骨基底。然而，在桡骨茎突狭窄性腱鞘炎的难治性病例中，已有报道称EPB肌腱远端插入拇指指间关节。我们推测，在EPB延长的患者中，EPB肌腱在拇指掌指关节远端更宽。本研究旨在评估伸肌腱宽度与EPB肌腱远端插入点之间的关系。
在18例男性和27例女性成年尸体的45只手中，解剖第一伸肌间隔并评估腱间隔的存在情况。在近节指骨中点测量伸肌腱宽度，并检查EPB肌腱延长、腱间隔存在率、性别与伸肌腱宽度之间的关系。
45例中，分别观察到腱间隔和EPB肌腱延长的有37例（82.2%）和23例（51.1%）。这两个因素的存在率与性别之间无显著差异。EPB延长组的平均伸肌腱宽度显著大于正常EPB组。EPB延长组伸肌腱宽度的截断值为7.12mm。
EPB延长组的伸肌腱宽度比正常EPB组宽，表明EPB肌腱宽度的差异可用于识别EPB延长的各种解剖变异。
