BACKGROUND De-Quervain’s tenosynovitis is a disorder arising from the compression and irritation of the first dorsal extensor compartment of the wrist.Patients who fail conservative treatment modalities are candidate...BACKGROUND De-Quervain’s tenosynovitis is a disorder arising from the compression and irritation of the first dorsal extensor compartment of the wrist.Patients who fail conservative treatment modalities are candidates for surgical release.However,risks with surgery include damage to the superficial radial nerve and an incomplete release due to inadequate dissection.Currently,there is a paucity of literature demonstrating the exact anatomic location of the first dorsal extensor compartment in reference to surface anatomy.Thus,this cadaveric study was performed to determine the exact location of the first extensor compartment and to devise a reliable surgical incision to prevent complications.AIM To describe the location of the first dorsal compartment in relation to bony surface landmarks to create replicable surgical incisions.METHODS Six cadaveric forearms,including four left and two right forearm specimens were dissected.Dissections were performed by a single fellowship trained upper extremity orthopaedic surgeon.Distance of the first dorsal compartment from landmarks such as Lister’s tubercle,the wrist crease,and the radial styloid were calculated.Other variables studied included the presence of the superficial radial nerve overlying the first dorsal compartment,additional compartment subsheaths,number of abductor pollicis longus(APL)tendon slips,and the presence of a pseudo-retinaculum.RESULTS Distance from the radial most aspect of the wrist crease to the extensor retinaculum was 5.14 mm±0.80 mm.The distance from Lister’s tubercle to the distal aspect of the extensor retinaculum was 13.37 mm±2.94 mm.Lister’s tubercle to the start of the first dorsal compartment was 18.43 mm±2.01 mm.The radial styloid to the initial aspect of the extensor retinaculum measured 2.98 mm±0.99 mm.The retinaculum length longitudinally on average was 26.82 mm±3.34 mm.Four cadaveric forearms had separate extensor pollicis brevis compartments.The average number of APL tendon slips was three.A pseudo-retinaculum was present in four cadavers.Two cadavers had a superficial radial nerve that crossed over the first dorsal compartment and retinaculum proximally(7.03 mm and 13.36 mm).CONCLUSION An incision that measures 3 mm proximal from the radial styloid,2 cm radial from Lister’s tubercle,and 5 mm proximal from the radial wrist crease will safely place surgeons at the first dorsal compartment.展开更多
Objective:To systematically evaluate the clinical efficacy of extracorporeal shock wave in the treatment of stenosing tenosynovitis of radius styloid process.Methods:All randomized controlled trials of extracorporeal ...Objective:To systematically evaluate the clinical efficacy of extracorporeal shock wave in the treatment of stenosing tenosynovitis of radius styloid process.Methods:All randomized controlled trials of extracorporeal shock wave in the treatment of stenotic tenosynovitis of radius styloid process were retrieved by computer.Two researchers independently screened,extracted and incorporated the literature into the literature evaluation.The quality evaluation was carried out with the bias risk assessment tool provided by Cochrane Collaboration Network,and the meta-analysis was carried out with RevMan 5.3 software.Result:According to the prescribed retrieval method,there were 8 articles and 447 subjects.The results showed that the effective rate of extracorporeal shock wave was(OR=5.37,95%CI(2.85,10.12),P<0.00001)compared with other therapies,and the difference was statistically significant.Meanwhile,there were significant differences in VAS pain score and Cooney dysfunction score.Conclusion:Extracorporeal shock wave can effectively relieve the pain symptoms of stenosing tenosynovitis of the radius styloid process,improve wrist dysfunction and improve the clinical efficiency of stenosing tenosynovitis of the radius styloid process,but a large number of high-quality studies are needed to provide more sufficient evidence.展开更多
目的观察温针灸联合局部封闭治疗桡骨茎突狭窄性腱鞘炎的临床疗效。方法选取68例桡骨茎突狭窄性腱鞘炎患者随机分成观察组和对照组(每组各34例),对照组给予单纯局部封闭治疗,观察组在对照组基础上给予温针灸治疗,观察两组患者治疗前后...目的观察温针灸联合局部封闭治疗桡骨茎突狭窄性腱鞘炎的临床疗效。方法选取68例桡骨茎突狭窄性腱鞘炎患者随机分成观察组和对照组(每组各34例),对照组给予单纯局部封闭治疗,观察组在对照组基础上给予温针灸治疗,观察两组患者治疗前后视觉模拟评分法(visual analog scale,VAS)、主要症状及体征评分,比较治疗后两组患者临床疗效。结果治疗后,两组患者VAS评分和主症及体征评分总分均较本组治疗前有所降低,差异有统计学意义(P<0.05或P<0.01),且观察组评分均低于对照组,差异有统计学意义(P<0.05);观察组总有效率高于对照组,两组比较差异有统计学意义(P<0.05)。结论温针灸联合局部封闭治疗桡骨茎突狭窄性腱鞘炎效果显著,且优于单纯局部封闭治疗,值得临床进一步研究推广。展开更多
In order to observe the therapeutic effect of external therapy of "RUYI JINHUANG SAN" (RJS) and 25 % magnesium sulfate solution (MSS) on radial styloid process tenosynovitis (RSPT), 200 cases of RSPT were di...In order to observe the therapeutic effect of external therapy of "RUYI JINHUANG SAN" (RJS) and 25 % magnesium sulfate solution (MSS) on radial styloid process tenosynovitis (RSPT), 200 cases of RSPT were divided into two groups: the treated and the control, which were treated for three weeks by the external application of RJS and MSS and by local blockage, respectively; the effective rates of the two groups were observed after the treatment courses. The results showed that the effective rates of the treated and the control were 94 % and 93 %, respectively; the comparison of the two groups showed no significant difference (P > 0.01) through χ2 test, suggesting that RJS and MSS have a strong function to remove the swellings and pains.展开更多
文摘BACKGROUND De-Quervain’s tenosynovitis is a disorder arising from the compression and irritation of the first dorsal extensor compartment of the wrist.Patients who fail conservative treatment modalities are candidates for surgical release.However,risks with surgery include damage to the superficial radial nerve and an incomplete release due to inadequate dissection.Currently,there is a paucity of literature demonstrating the exact anatomic location of the first dorsal extensor compartment in reference to surface anatomy.Thus,this cadaveric study was performed to determine the exact location of the first extensor compartment and to devise a reliable surgical incision to prevent complications.AIM To describe the location of the first dorsal compartment in relation to bony surface landmarks to create replicable surgical incisions.METHODS Six cadaveric forearms,including four left and two right forearm specimens were dissected.Dissections were performed by a single fellowship trained upper extremity orthopaedic surgeon.Distance of the first dorsal compartment from landmarks such as Lister’s tubercle,the wrist crease,and the radial styloid were calculated.Other variables studied included the presence of the superficial radial nerve overlying the first dorsal compartment,additional compartment subsheaths,number of abductor pollicis longus(APL)tendon slips,and the presence of a pseudo-retinaculum.RESULTS Distance from the radial most aspect of the wrist crease to the extensor retinaculum was 5.14 mm±0.80 mm.The distance from Lister’s tubercle to the distal aspect of the extensor retinaculum was 13.37 mm±2.94 mm.Lister’s tubercle to the start of the first dorsal compartment was 18.43 mm±2.01 mm.The radial styloid to the initial aspect of the extensor retinaculum measured 2.98 mm±0.99 mm.The retinaculum length longitudinally on average was 26.82 mm±3.34 mm.Four cadaveric forearms had separate extensor pollicis brevis compartments.The average number of APL tendon slips was three.A pseudo-retinaculum was present in four cadavers.Two cadavers had a superficial radial nerve that crossed over the first dorsal compartment and retinaculum proximally(7.03 mm and 13.36 mm).CONCLUSION An incision that measures 3 mm proximal from the radial styloid,2 cm radial from Lister’s tubercle,and 5 mm proximal from the radial wrist crease will safely place surgeons at the first dorsal compartment.
基金Central level public welfare research institutes basic scientific research operating expenses independent topic(No.ZZ11-034).
文摘Objective:To systematically evaluate the clinical efficacy of extracorporeal shock wave in the treatment of stenosing tenosynovitis of radius styloid process.Methods:All randomized controlled trials of extracorporeal shock wave in the treatment of stenotic tenosynovitis of radius styloid process were retrieved by computer.Two researchers independently screened,extracted and incorporated the literature into the literature evaluation.The quality evaluation was carried out with the bias risk assessment tool provided by Cochrane Collaboration Network,and the meta-analysis was carried out with RevMan 5.3 software.Result:According to the prescribed retrieval method,there were 8 articles and 447 subjects.The results showed that the effective rate of extracorporeal shock wave was(OR=5.37,95%CI(2.85,10.12),P<0.00001)compared with other therapies,and the difference was statistically significant.Meanwhile,there were significant differences in VAS pain score and Cooney dysfunction score.Conclusion:Extracorporeal shock wave can effectively relieve the pain symptoms of stenosing tenosynovitis of the radius styloid process,improve wrist dysfunction and improve the clinical efficiency of stenosing tenosynovitis of the radius styloid process,but a large number of high-quality studies are needed to provide more sufficient evidence.
文摘目的观察温针灸联合局部封闭治疗桡骨茎突狭窄性腱鞘炎的临床疗效。方法选取68例桡骨茎突狭窄性腱鞘炎患者随机分成观察组和对照组(每组各34例),对照组给予单纯局部封闭治疗,观察组在对照组基础上给予温针灸治疗,观察两组患者治疗前后视觉模拟评分法(visual analog scale,VAS)、主要症状及体征评分,比较治疗后两组患者临床疗效。结果治疗后,两组患者VAS评分和主症及体征评分总分均较本组治疗前有所降低,差异有统计学意义(P<0.05或P<0.01),且观察组评分均低于对照组,差异有统计学意义(P<0.05);观察组总有效率高于对照组,两组比较差异有统计学意义(P<0.05)。结论温针灸联合局部封闭治疗桡骨茎突狭窄性腱鞘炎效果显著,且优于单纯局部封闭治疗,值得临床进一步研究推广。
文摘In order to observe the therapeutic effect of external therapy of "RUYI JINHUANG SAN" (RJS) and 25 % magnesium sulfate solution (MSS) on radial styloid process tenosynovitis (RSPT), 200 cases of RSPT were divided into two groups: the treated and the control, which were treated for three weeks by the external application of RJS and MSS and by local blockage, respectively; the effective rates of the two groups were observed after the treatment courses. The results showed that the effective rates of the treated and the control were 94 % and 93 %, respectively; the comparison of the two groups showed no significant difference (P > 0.01) through χ2 test, suggesting that RJS and MSS have a strong function to remove the swellings and pains.
