Gontre Gil, Heifner John J, Jordan James A, Pannu Tejbir S, Herrera Fernando A
Department of Orthopedics, Texas Tech University Health Sciences Center, El Paso, TX.
Miami Orthopaedic Research Foundation, Miami, FL.
J Hand Surg Glob Online. 2024 Apr 10;6(4):510-513. doi: 10.1016/j.jhsg.2024.03.009. eCollection 2024 Jul.
Release of the first dorsal compartment is a described technique during volar approach for distal radius fracture fixation. Our objective was to determine whether release of the first dorsal compartment during volar approach for distal radius fracture fixation impacted corresponding symptoms in pre-existing de Quervain disease.
A prospective, randomized cohort study was performed with patients grouped for release (release group) or no release (control group) of the first dorsal compartment during volar approach for distal radius fracture fixation. Inclusion required a confirmed diagnosis of de Quervain disease within the 12 months preceding a distal radius fracture.
Patients in the release group were significantly less symptomatic than those in the control group at 3 and 6 months after surgery. Lateral pinch strength in the release group was significantly greater than that in the control group at 3 and 6 months after surgery.
The current results demonstrated a significantly greater reduction in de Quervain disease symptoms in the release group compared with the no release group during the short-term follow-up. This indicates that routine first dorsal compartment release during distal radius fracture fixation may expedite symptom relief in patients with de Quervain disease.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic I.
在桡骨远端骨折固定的掌侧入路中，第一背侧间室松解是一种已被描述的技术。我们的目的是确定在桡骨远端骨折固定的掌侧入路中进行第一背侧间室松解是否会影响既往存在的桡骨茎突狭窄性腱鞘炎的相应症状。
进行了一项前瞻性随机队列研究，将患者分为在桡骨远端骨折固定的掌侧入路中进行第一背侧间室松解的组（松解组）和不进行松解的组（对照组）。纳入标准要求在桡骨远端骨折前12个月内确诊为桡骨茎突狭窄性腱鞘炎。
在术后3个月和6个月时，松解组患者的症状明显轻于对照组。术后3个月和6个月时，松解组的桡侧捏力明显大于对照组。
目前的结果表明，在短期随访中，松解组的桡骨茎突狭窄性腱鞘炎症状的减轻程度明显大于未松解组。这表明在桡骨远端骨折固定过程中常规进行第一背侧间室松解可能会加快桡骨茎突狭窄性腱鞘炎患者的症状缓解。
研究类型/证据水平：治疗性I级。
