Greenhill Dustin Adam, Thoder Joseph J, Abdelfattah Hesham
Department of Orthopaedic Surgery & Sports Medicine, Temple University Hospital, Philadelphia, Pennsylvania, USA.
BMJ Case Rep. 2017 Jul 31;2017:bcr-2017-220517. doi: 10.1136/bcr-2017-220517.
DeQuervain's tenosynovitis is a common cause of radial-sided wrist pain. Symptoms result from a narrow first dorsal compartment and associated tendinosis of the enclosed extensor pollicis brevis and/or abductor pollicis longus (APL). Surgical intervention, offered when conservative measures fail to adequately relieve symptoms, requires a detailed understanding of potentially aberrant anatomy in order to avoid persistence or recurrence of symptoms. We describe a case whereby the patient presented with complaints of thumb triggering in extension and associated disabling first dorsal compartment tendinosis. Intraoperatively, after supernumerary tendons were identified and addressed, the APL was at risk for subluxation over a prominent fibroosseous ridge. Routine first dorsal compartment release alone may have failed to address all of this patient's pathology.
桡骨茎突狭窄性腱鞘炎是桡侧腕部疼痛的常见原因。症状源于第一背侧腱鞘狭窄以及所包裹的拇短伸肌和/或拇长展肌（APL）相关的肌腱病。当保守治疗无法充分缓解症状时进行手术干预，需要详细了解可能存在的异常解剖结构，以避免症状持续或复发。我们描述了一例患者，其主诉为拇指伸展时卡顿以及伴有致残性的第一背侧腱鞘肌腱病。术中，在识别并处理多余肌腱后，APL有在一个突出的纤维骨性嵴上半脱位的风险。仅进行常规的第一背侧腱鞘松解术可能无法解决该患者的所有病理问题。
