Department of Orthopaedic Surgery, Seikeikai Hospital, Sakai City, Osaka, Japan.
J Orthop Surg (Hong Kong). 2020 Jan-Apr;28(2):2309499020922310. doi: 10.1177/2309499020922310.
Stenosing tenosynovitis of the extensor digiti minimi (EDM) without trauma is very rare. We report a 21-year-old woman who presented with dorsoulnar wrist pain during palmar wrist flexion and soft tissue mass at the site of pain. Ultrasonography and magnetic resonance imaging showed a round mass radial to the EDM tendon. Conservative treatment for 3 months failed to improve the patient's pain levels. Intraoperative findings revealed smaller radial slip of the EDM tendon, and bifurcation of these was under the distal portion of the extensor retinaculum (ER). Surgical release of the ER, resection of the smaller slip of the EDM tendon, and tenosynovectomy were performed. Histological examination showed tenosynovitis. At the final follow-up 1 year postoperatively, she was asymptomatic. A literature review suggested that stenosing tenosynovitis of the EDM tendon might be caused by frequent use of the hand with a background history of bifurcation of the EDM tendon.
无创伤性的小指伸肌腱狭窄性腱鞘炎非常罕见。我们报告了一例 21 岁女性,她在手掌屈腕时出现背侧尺侧腕疼痛和疼痛部位的软组织肿块。超声和磁共振成像显示,EDM 肌腱的桡侧有一个圆形肿块。3 个月的保守治疗未能改善患者的疼痛程度。术中发现 EDM 肌腱的较小桡侧滑出,这些分叉位于伸肌支持带(ER)的远端部分下方。行 ER 松解、较小的 EDM 肌腱滑出部分切除和腱鞘炎切除术。组织学检查显示腱鞘炎。术后 1 年的最终随访时,她无症状。文献复习提示,EDM 肌腱的狭窄性腱鞘炎可能由手部频繁使用和 EDM 肌腱分叉的背景病史引起。