Millis M B, Millender L H, Nalebuff E A
J Bone Joint Surg Am. 1976 Sep;58(6):801-5.
In nineteen hands (seventy-four fingers) of eleven women and one man with rheumatoid arthritis there was restriction of active and passive motion of the proximal interphalangeal joints, with signs of flexor tenosynovitis but no clinical or roentgenographic evidence of involvement of the joint. The nineteen hands were treated by flexor tenosynovectomy (palm only in nine, palm and carpal tunnel in five, both palm and digits in four, and digit, palm, and wrist in one) combined with manipulation of the joint under regional anesthesia. After an average follow-up of twenty-one months (range, six to thirty-six months), the average range of active motion had increased from 40 to 84 degrees and the average range of passive motions, from 57 to 87 degrees. Only three patients had unsatisfactory results, one because of persistent unexplained swelling and two because of recurrence of the tenosynovitis.
在11名女性和1名男性类风湿关节炎患者的19只手（74根手指）中，近端指间关节的主动和被动活动受限，有屈肌腱腱鞘炎的体征，但无关节受累的临床或X线证据。这19只手接受了屈肌腱滑膜切除术（9只仅切除手掌滑膜，5只切除手掌和腕管滑膜，4只切除手掌和手指滑膜，1只切除手指、手掌和腕部滑膜），并在区域麻醉下对关节进行手法操作。平均随访21个月（范围为6至36个月）后，主动活动的平均范围从40度增加到84度，被动活动的平均范围从57度增加到87度。只有3例患者效果不理想，1例是由于持续出现无法解释的肿胀，2例是由于腱鞘炎复发。
