骨性突起与狭窄性腱鞘炎相关解剖学的临床研究

Clinical and anatomic observation on the relation between bony process and stenosing tenovaginitis

目的:探讨骨性突起在狭窄性腱鞘炎形成中的作用及解剖学基础。方法:对14例成人防腐固定标本进行解剖学观察,其中,拇掌指关节6例,腕关节6例,肩关节2例。用部分腱鞘切除和部分骨性突起切除方法治疗狭窄性腱鞘炎患者50例,计扳机指22例,桡骨茎突狭窄性腱鞘炎18例,肱二头肌长头肌腱腱鞘炎8例,尺侧腕屈肌肌腱腱鞘炎2例。结果:术后所有病例疼痛消失,42例得以随访,随访时间7～12个月,40例治愈,2例有效,治愈率达到96%。同时,解剖学研究发现,关节在某一个固定的位置时易被骨性突起损伤。结论:经临床和解剖学研究证实,骨性突起与狭窄性腱鞘炎的形成有密切的关系。

AIM:To study the effect of bony process on the formation of stenosing tenovaginitis and its anatomical basis. METHODS:Anatomic observation was performed at 14 adult cadaver samples. Of all 14 cases, there were 6 cases of 1st metacarpophalangeal joints, 6 cases of wrist joints, and 2 cases of shoulder joints. Fifty cases of stenosing tenovaginitis, including 22 cases of trigger finger, 18 cases of de Quervain's disease, 8 cases of Long head of biceps brachii muscle and 2 cases of flexor carpi ulnaris muscle, were treated by cutting bony process and tendon sheath partly. RESULTS:Forty two patients were followed up for 7 12 months postoperatively. Forty one patients were cured and 2 cases gained effective improvement. The cure rate reached to 96% . Moreover, anatomy observation showed that all cases had a fix joint location in which tendon and tendon sheath were apt to be injured by bony process.