Kerboull L, Leviet D
Hôpital Cochin, Service d'Orthopédie A, Paris.
Ann Chir Main Memb Super. 1995;14(3):135-41. doi: 10.1016/s0753-9053(05)80311-4.
The results of a 27 cases of flexor carpi radialis tenosynovitis, operated between 1984 and 1992 and followed for an average of 30 months, are reported. This study confirms the female predominance of this disease (25 women for two men) and its development mainly after the age of fifty. Pain along the course of the tendon is a constant sign, frequently associated with dysaesthesia in the territory of the palmaris brevis branch of the median nerve as well as synovial swelling. Surgery was indicated because of failure of apparently correctly conducted medical treatment. The technique consists of synovectomy and resection of all sources of irritation of the tendon in its sheath. The development of trapezium or scaphoid osteophytes is a common cause of irritation. The functional result obtained was good or excellent in 22 cases. This study confirmed the existence of a close relationship between the development of flexor carpi radialis tenosynovitis and the presence of external osteoarthritis of the carpus, as this combination of lesions was observed in 20 of the 27 cases. Carpal osteoarthritic lesions appear to be responsible for the great majority of cases of flexor carpi radialis tendinitis observed in women over the age of 50 years. Following failure of medical treatment, surgical treatment is effective provided it includes treatment of any osteoarthritic lesions present.
本文报告了1984年至1992年间接受手术治疗的27例桡侧腕屈肌腱腱鞘炎患者的结果，平均随访30个月。本研究证实了该病女性居多（男女比例为25:2），且主要在50岁以后发病。沿肌腱走行的疼痛是一个持续的症状，常伴有正中神经掌短肌支支配区域的感觉异常以及滑膜肿胀。因看似正确实施的药物治疗失败而进行手术。手术技术包括滑膜切除术和切除腱鞘内肌腱的所有刺激源。大多角骨或舟骨骨赘的形成是常见的刺激原因。22例患者的功能结果为良好或优秀。本研究证实桡侧腕屈肌腱腱鞘炎的发生与腕关节外部骨关节炎的存在密切相关，因为在27例患者中有20例观察到了这种病变组合。腕关节骨关节炎病变似乎是50岁以上女性中观察到的大多数桡侧腕屈肌腱炎病例的病因。药物治疗失败后，手术治疗有效，前提是包括对任何存在的骨关节炎病变的治疗。
