PDF(Pubmed)
Abstract：
The first extensor wrist compartment (FEWC) displays significant variants. This review highlights all possible variants that may be associated with the occurrence and pathophysiology of de Quervain\'s tenosynovitis. A thorough search of PubMed and MEDLINE databases, following the PRISMA guidelines, was conducted from 2002 to 2022 to evaluate all FEWC variants, including the following: 1) the presence of an inter-tendinous septum, 2) the number of tendinous slips of the abductor pollicis longus (APL) and the extensor pollicis brevis (EPB) muscles, 3) their distal insertions and 4) the presence of a bony ridge within the FEWC. A total of 3878 wrists (1277 cadaveric and 1296 de Quervain patients) were included. Of the 1234 cadavers, a total of 701 (56.8%) were males and 533 (43.2%) were females. Regarding the 883 patients, 178 (20.2%) of them were males and 705 (79.8%) were females. An inter-tendinous septum was identified in 42.9% (47% of the patients\' wrists compared to 39.3% of the cadaveric wrists, p<0.0001). Cadaveric wrists presented two or more slips for the APL in a significantly higher percentage (92.5%, p < 0.0001) compared to de Quervain patients\' wrists (74.5%). Regarding the EPB muscle, de Quervain patients\' wrists had a single slip in 93% (p=0.0007) and two or more slips in 3.6%, compared to cadaveric wrists (a single slip in 87%, and two or more slips in 11%, p< 0.0001). A bony ridge over the radial styloid process was recorded in 58.9% of the cadaveric wrists compared to 17.8% of the patients\' wrists (p < 0.0001). Remarkable diversity concerning the structures within the FEWC was reported. The presence of an inter-tendinous septum dividing the FEWC and a single EPB muscle slip is more likely to be found in patients with de Quervain\'s disease.
摘要：
第一伸肌腕部（FEWC）显示出明显的变体。这篇综述强调了所有可能的变异，这些变异可能与deQuervain的腱鞘炎的发生和病理生理学有关。彻底搜索PubMed和MEDLINE数据库，遵循PRISMA准则，从2002年到2022年进行了评估，以评估所有FEWC变体，包括以下内容:1)肌腱间隔的存在，2）长肌外展肌（APL）和短伸肌（EPB）肌的肌腱滑脱数，3）它们的远端插入和4）FEWC内存在骨脊。总共包括3878个手腕（1277个尸体和1296个deQuervain患者）。在1234具尸体中，男性共701人(56.8%),女性共533人(43.2%)。关于883名患者，其中男性178人（20.2％），女性705人（79.8％）。在42.9%的患者中发现了腱间隔(47%的患者手腕与39.3%的尸体手腕相比,p<0.0001)。尸体腕部出现两次或两次以上的APL滑倒的百分比明显更高（92.5％，p<0.0001)与deQuervain患者的手腕(74.5%)相比。关于EPB肌肉，deQuervain患者的手腕有93％的单滑脱（p=0.0007）和3.6％的两个或多个滑脱，与尸体手腕相比(87%的单滑，11%的两个或两个以上的失误，p<0.0001)。在58.9％的尸体手腕中记录到radial茎突上的骨脊，而在17.8％的患者手腕中记录到（p<0.0001）。报告了FEWC内结构的显着多样性。在deQuervain病的患者中，更可能发现存在分隔FEWC的腱间间隔和单个EPB肌肉滑脱。
