Landstrӧm Jerone T
Pacific Hand Surgery Center, Tamuning, GU.
SAGE Open Med Case Rep. 2020 Nov 27;8:2050313X20977389. doi: 10.1177/2050313X20977389. eCollection 2020.
Surgical treatment of primary and recurrent volar radial wrist-forearm ganglia has yielded higher recurrence rates of ganglia when compared to surgical treatment of dorsal wrist ganglia. The published surgical literature hypothesizes that the variability in etiology of volar radial wrist-forearm ganglia may account for the higher surgical recurrence rates of these ganglia. Currently, the literature states that volar radial wrist-forearm ganglia may be secondary to arthritic intercarpal joints, carpal interosseous ganglia, or by mechanical stress within tendon sheaths, joint capsules, and ligaments. The literature has not reported pathology isolated to the flexor carpi radialis tendon and its tendon sheath at the volar trapezial fibro-osseous synovial sheath tunnel as a cause of volar radial wrist-forearm ganglia. This case series reports findings of pathology isolated to the flexor carpi radialis tendon at the trapezial fibro-osseous synovial sheath tunnel that caused primary and recurrent volar radial wrist-forearm ganglia. The pathology identified in this case series hypothesizes an additional etiologic factor in development of volar radial wrist-forearm ganglia. Surgeon awareness of potential pathology of the flexor carpi radialis tendon at the trapezial fibro-osseous synovial sheath tunnel may reduce recurrence rates of volar radial wrist-forearm ganglia treated by surgical intervention.
与腕背侧腱鞘囊肿的手术治疗相比，原发性和复发性桡侧腕掌部腱鞘囊肿的手术治疗复发率更高。已发表的外科文献推测，桡侧腕掌部腱鞘囊肿病因的多样性可能是这些囊肿手术复发率较高的原因。目前，文献表明桡侧腕掌部腱鞘囊肿可能继发于关节炎性腕骨间关节、腕骨间腱鞘囊肿，或继发于腱鞘、关节囊和韧带内的机械应力。文献尚未报道桡侧腕掌部腱鞘囊肿的病因是局限于桡侧腕屈肌腱及其在大多角骨纤维骨性滑膜鞘管处的腱鞘。本病例系列报告了局限于大多角骨纤维骨性滑膜鞘管处桡侧腕屈肌腱的病变，这些病变导致了原发性和复发性桡侧腕掌部腱鞘囊肿。本病例系列中确定的病变推测了桡侧腕掌部腱鞘囊肿发生的另一个病因。外科医生意识到大多角骨纤维骨性滑膜鞘管处桡侧腕屈肌腱的潜在病变，可能会降低手术干预治疗的桡侧腕掌部腱鞘囊肿的复发率。
