From the Department of Orthopaedic Surgery, Houston Methodist Hospital; and the Department of Surgery, the Division of Plastic Surgery, the Department of Medicine, the Section of Health Services Research, and the Department of Orthopedic Surgery, Baylor College of Medicine.
Plast Reconstr Surg. 2019 Aug;144(2):389-393. doi: 10.1097/PRS.0000000000005827.
The authors conducted this study to determine whether septation of the first dorsal compartment is more prevalent in de Quervain tenosynovitis, and whether this contributes to failure of corticosteroid injection therapy.
A retrospective review of 79 consecutive patients (85 wrists) with symptomatic de Quervain tenosynovitis treated with surgical release was performed. The number of corticosteroid injections performed preoperatively and the presence of first dorsal compartment septation determined intraoperatively were recorded. Correlation between the number of steroid injections and the presence of septation was evaluated. In addition, 48 matched cadaver upper extremities (96 wrists) that had not previously undergone surgery for de Quervain disease were evaluated for the presence of first dorsal compartment septation. The prevalence of septation was compared between matched wrists and against the surgically treated clinical cohort.
In the clinical cohort, 61.2 percent of wrists contained a septated first dorsal compartment. There was no correlation between the presence of a septated first dorsal compartment and the number of steroid injections before surgical release. In the cadaver portion of the study, 72.9 percent of wrists contained septa. There was no significant difference in the prevalence of septated first dorsal compartments between groups.
In the present study, the majority of wrists contained a septated first dorsal compartment, with no difference in the prevalence of septa between surgically treated patients and a cadaver sample that had not undergone prior surgical release. Furthermore, there was no correlation between the presence of septa and the number of preoperative corticosteroid injections administered.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.
作者进行本研究旨在确定分隔第一背侧间隔在德奎文氏腱鞘炎中是否更为常见，以及这是否导致皮质类固醇注射治疗失败。
对 79 例（85 腕）接受手术松解治疗的有症状德奎文氏腱鞘炎患者进行回顾性研究。记录术前皮质类固醇注射次数和术中发现的第一背侧间隔是否存在分隔。评估类固醇注射次数与分隔存在之间的相关性。此外，评估了 48 个匹配的尸体上肢（96 腕），这些上肢以前未因德奎文氏病而行手术治疗，以评估第一背侧间隔是否存在分隔。将存在分隔的比例与匹配的腕部进行比较，并与手术治疗的临床队列进行比较。
在临床队列中，61.2%的腕部存在分隔的第一背侧间隔。存在分隔的第一背侧间隔与手术松解前皮质类固醇注射次数之间无相关性。在研究的尸体部分，72.9%的腕部存在间隔。两组之间存在分隔的第一背侧间隔的比例无显著差异。
在本研究中，大多数腕部存在分隔的第一背侧间隔，手术治疗患者和未接受先前手术松解的尸体样本之间间隔的存在率无差异。此外，间隔的存在与术前皮质类固醇注射次数之间无相关性。
临床问题/证据水平：风险，III 级。
