Lanzetta M, Foucher G
SOS Main Strasbourg, France.
Plast Reconstr Surg. 1995 Aug;96(2):408-12. doi: 10.1097/00006534-199508000-00023.
We report on a series of 25 patients (26 cases) presenting an association of Wartenberg's radial neuritis and De Quervain's tenosynovitis. In all patients the diagnosis was made on clinical grounds. In group 1, conservative treatment of Wartenberg's syndrome was used in 16 patients (associated with surgical release of the first extensor compartment in 5 patients). Of the 14 patients available for follow-up at an average of 15 months, 9 (64 percent) were excellent and good results. In group 2 (11 patients, with 1 failure of conservative treatment), surgical treatment addressed both conditions. Neurolysis has to be performed at the classic proximal site of entrapment (constant excellent and good results), for the 2 cases of neurolysis at the styloid level gave fair results. It is particularly important to identify an associated Wartenberg's syndrome before performing a release of the first dorsal compartment to avoid incomplete relief or even aggravation of neuritis, exposing the surgeon to litigation.
我们报告了一系列25例患者(26例病例),这些患者同时患有瓦滕伯格桡神经炎和桡骨茎突狭窄性腱鞘炎。所有患者均根据临床症状做出诊断。在第1组中,16例患者采用了瓦滕伯格综合征的保守治疗方法(其中5例患者同时进行了第一伸肌间隔的手术松解)。在平均随访15个月的14例患者中,9例(64%)效果为优或良。在第2组(11例患者,其中1例保守治疗失败)中,采用手术治疗两种病症。对于2例在茎突水平进行神经松解的病例,效果一般,而在经典的近端卡压部位进行神经松解则始终能取得优或良的效果。在进行第一背侧间隔松解之前,识别出相关的瓦滕伯格综合征尤为重要,以避免神经炎症缓解不完全甚至加重,使外科医生面临诉讼风险。