Optimal surgical approach for the treatment of Quervains disease: A surgical-anatomical study  

作　　者：Alexander R Poublon Gert-Jan Kleinrensink Anton LA Kerver J Henk Coert Erik T Walbeehm 

机构地区：[1]Department of Neuroscience and Anatomy, Erasmus MC [2]Department of Plastic and Reconstructive surgery, Catharina Ziekenhuis [3]Department of Plastic Surgery, UMC Utrecht [4]Department of Plastic Surgery, Radboud UMC

出　　处：《World Journal of Orthopedics》2018年第2期7-13,共7页世界骨科杂志（英文版）

摘　　要：AIM To determine which of the common used incision techniques has the lowest chance of iatrogenic damage to the nerves which at risk are the superficial branch of the radial nerve(SBRN) and the Lateral Antebrachial Cutaneous Nerve(LABCN).METHODS Twenty embalmed arms were dissected and the course of the SBRN and the LABCN in each individual arm was marked and the distance between the two branches of the SBRN at the location of the First Extensor Compartment(FEC) was measured. This data was used as input in a visualization tool called Computer Assisted Anatomy Mapping(CASAM) to map the course of the nerves in each individual arm. RESULTS This image visualizes that in 90% of the arms, one branch of the SBRN crosses the FEC and one branch runs volar to the compartment. The distance between the two branches was 7.8 mm at the beginning of the FEC and 10.2 mm at the end. Finally the angle of incision at which the chance of damage to the nerves is lowest, is 19.4 degrees volar to the radius.CONCLUSION CASAM shows the complexity of the course of the SBRN over the FEC. None of the four widely used incision techniques has a significantly lower chance of iatrogenic nerve damage. Surgical skills are paramount to prevent iatrogenic nerve damage.AIM To determine which of the common used incision techniques has the lowest chance of iatrogenic damage to the nerves which at risk are the superficial branch of the radial nerve(SBRN) and the Lateral Antebrachial Cutaneous Nerve(LABCN).METHODS Twenty embalmed arms were dissected and the course of the SBRN and the LABCN in each individual arm was marked and the distance between the two branches of the SBRN at the location of the First Extensor Compartment(FEC) was measured. This data was used as input in a visualization tool called Computer Assisted Anatomy Mapping(CASAM) to map the course of the nerves in each individual arm. RESULTS This image visualizes that in 90% of the arms, one branch of the SBRN crosses the FEC and one branch runs volar to the compartment. The distance between the two branches was 7.8 mm at the beginning of the FEC and 10.2 mm at the end. Finally the angle of incision at which the chance of damage to the nerves is lowest, is 19.4 degrees volar to the radius.CONCLUSION CASAM shows the complexity of the course of the SBRN over the FEC. None of the four widely used incision techniques has a significantly lower chance of iatrogenic nerve damage. Surgical skills are paramount to prevent iatrogenic nerve damage.

关 键 词：De Quervain’s TENOSYNOVITIS First DORSAL COMPARTMENT release WRIST SURGERY 

分 类 号：R[医药卫生]