Brigham and Women's Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.
Hand (N Y). 2024 Oct;19(7):1159-1165. doi: 10.1177/15589447231164746. Epub 2023 Apr 19.
De Quervain tenosynovitis of the wrist is a common pathology. The primary aim of this study is to determine the prevalence of extensor pollicis brevis and abductor pollicis longus (APL) anatomical variations in association with de Quervain tenosynovitis. The secondary aim was to compare additional patient-specific factors associated with de Quervain tenosynovitis.
This retrospective study included 172 patients with de Quervain tenosynovitis who underwent first dorsal compartment release and 179 patients with thumb carpometacarpal (CMC) arthritis who underwent thumb CMC arthroplasty between August 1, 2007, and May 1, 2022. The CMC group was chosen as the control group because the study surgeons perform APL suspensionplasty as the primary procedure for thumb CMC arthritis, allowing for a comparison group without de Quervain tenosynovitis. Exclusion criteria included patients undergoing revision surgery, patients undergoing thumb CMC procedure other than APL suspensionplasty, and patients with both CMC and first dorsal compartment diagnoses. Demographics, clinical variables, and intraoperative findings were collected through retrospective chart reviews.
Patients in the de Quervain tenosynovitis group tended to be younger (51 years, range: 23-92 years vs 63 years, range: 28-85 years), women (86.1% vs 77.1%), and more commonly of African American or black race (15.7% vs 3.9%) and Asian race (5.2% vs 0%). There was a higher prevalence of tendon subcompartments (79.1% vs 64.2%), but fewer number of APL slips (38.3% vs 20.7% 2 or fewer slips) seen in the de Quervain tenosynovitis group.
Anatomical variation exists between patients with and without de Quervain tenosynovitis. The presence of tendon subcompartments but not an increased number of tendon slips is associated with de Quervain tenosynovitis.
手腕部的 De Quervain 腱鞘炎是一种常见的疾病。本研究的主要目的是确定伸拇短肌和外展拇长肌（APL）解剖变异与 De Quervain 腱鞘炎的相关性。次要目的是比较与 De Quervain 腱鞘炎相关的其他患者特定因素。
本回顾性研究纳入了 2007 年 8 月 1 日至 2022 年 5 月 1 日期间接受第一背侧间隔松解术的 172 例 De Quervain 腱鞘炎患者和接受拇指腕掌关节炎（CMC）关节成形术的 179 例拇指 CMC 关节炎患者。选择 CMC 组作为对照组，因为研究外科医生将 APL 悬吊术作为拇指 CMC 关节炎的主要手术，可比较无 De Quervain 腱鞘炎的对照组。排除标准包括接受翻修手术的患者、接受拇指 CMC 手术但不是 APL 悬吊术的患者以及同时患有 CMC 和第一背侧间隔诊断的患者。通过回顾性图表审查收集人口统计学、临床变量和术中发现。
De Quervain 腱鞘炎组患者的年龄较小（51 岁，范围：23-92 岁比 63 岁，范围：28-85 岁）、女性（86.1%比 77.1%）、非裔美国人或黑人（15.7%比 3.9%）和亚洲人（5.2%比 0%）更为常见。De Quervain 腱鞘炎组患者的肌腱亚区（79.1%比 64.2%）更为常见，但 APL 滑出的数量较少（38.3%比 20.7%，即 2 个或更少滑出）。
De Quervain 腱鞘炎患者与无 De Quervain 腱鞘炎患者之间存在解剖学差异。存在肌腱亚区但没有增加的肌腱滑出与 De Quervain 腱鞘炎有关。
