三种封闭方法治疗腱鞘囊肿的疗效比较

自2000年8月-2004年7月我们应用三种封闭方法共治疗腱鞘囊肿154例，在有效率、一次性治愈率、复发率和未愈率4个方面进行了比较研究。     

磁共振成像在早期类风湿性关节炎诊断中的价值

目的 探讨MRI在早期类风湿性关节炎(rheumatoid arthritis, RA)诊断中的价值.方法 回顾性分析35例临床确诊早期RA患者的手腕关节X线和MRI图像.使用Philips Achieva 3.0 T磁共振扫描仪.结果 在35例初诊RA患者中,MRI表现包括滑膜增生和滑膜炎、腱鞘炎、关节积液、骨质侵蚀...     

消瘀膏治疗腱鞘炎的护理体会

目的探讨消瘀膏治疗腱鞘炎的护理。方法 2010年5月至2012年5月采用中药消瘀膏贴敷、健康宣教等措施,规范护理本院门诊37例腱鞘炎,其中手指屈肌腱腱鞘炎18例,桡骨茎突狭窄性腱鞘炎13例,肱二头肌长头腱鞘炎6例。结果 37例：治愈33例,显效3例,无效1例,总有效率97%。结论合理的应用中药消瘀膏治疗腱鞘炎,有助于患者早日康复。     

Radial extracorporeal pressure pulse therapy for the primary long bicipital tenosynovitis a prospective randomized controlled study

Long bicipital tenosynovitis is regarded as one of the common causes of shoulder pain and dysfunction. The traditional therapeutic approach includes a variety of conservative treatments, but these treatments are not substantiated, owing to the lack of proven clinical efficacy. Radial extracorporeal shock wave therapy (rESWT) uses a pneumatically generated and radially propagating low-energy pressure pulse and has been clinically shown to be a new alternative form of treating refractory soft tissue inflammation. While treating patients suffering from long bicipital tenosynovitis, a randomized, controlled trial was conducted to analyze the effects of radial shock wave therapy on pain and function. Seventy-nine adults with long bicipital tenosynovitis were randomized to receive either active (1500 pulses, 8 Hz, 3 bars) or sham treatment through four sessions that were held once a week. All of these adults were assessed before treatment and at time intervals of 1, 3 and 12 months since the completion of the treatment. The outcomes were measured through the visual analogue scale (VAS) and L'Insalata shoulder questionnaire. Mean VAS in the rESWT group showed significant and sustained reduction from 5.67 ± 1.32 at baseline to 2.58 ± 1.49 at one month, 1.83 ± 1.25 at three months and 1.43 ± 0.94 at 12 months from baseline, whereas the sham group's mean VAS was 6.04 ± 0.97 before treatment and stabilized at 5.57 ± 0.84 at 12 months. Similar trends were found for the function scores. Mean scores were increased after rESWT from 60.57 ± 6.91 at baseline to 79.85 ± 6.59 at 1 month and 83.44 ± 5.21 at 12 months from baseline. Both pain and function scores showed significant differences between the two groups (p < 0.001). The rESWT group consisted of "invalid conservative treatment subgroup" and "none conservative treatment subgroup." Both groups showed good recovery and prognosis. Therefore, we recommend rESWT in treating primary long bicipital tenosynovitis.     

关节镜下治疗桡骨茎突狭窄性腱鞘炎的病例对照研究

目的 :探讨关节镜下治疗桡骨茎突狭窄性腱鞘炎的临床疗效。方法 :2009年8月至2013年7月收治桡骨茎突狭窄性腱鞘炎患者99例,分为3组:关节镜治疗组(32例,男6例,女26例),外科手术切开腱鞘组(34例,男7例,女27例)和封闭治疗组(33例,男6例,女27例)。观察并比较3组在治疗前、治疗后1周和治疗后1个月腕部及拇指静息状态下疼痛程度、活动状态下疼痛程度、局部压痛程度、局部肿胀情况、腕部及拇指活动情况及总体症状评分方面的差异。同时计算3组在不同时间点的总有效率。结果:随访1周和1个月后,关节镜治疗组和外科手术切开腱鞘组活动疼痛评分低于封闭治疗组(P=0.044和0.039)。1个月后关节镜治疗组和外科手术切开腱鞘组局部压痛评分低于封闭治疗组(P=0.017)。随访1周和1个月后关节镜治疗组和外科手术切开腱鞘组总体症状评分均低于封闭治疗组(P=0.007和0.015)。治疗后随访1周关节镜治疗组、外科手术切开腱鞘组和封闭治疗组总有效率比较,差异无统计学意义(P=0.213),但随访1个月后总有效率差异有统计学意义(P=0.006)。结论:相比传统手术切开腱鞘治疗和封闭治疗,关节镜下治疗桡骨茎突狭窄性腱鞘炎疗效满意,手术创伤小,安全性高,并发症少,在狭窄性腱鞘炎治疗中有一定的优越性。     

Trigger Wrist

Trigger wrist is a relatively rare disease compared to trigger finger, which is the most common disorder found in hands. Patients with trigger wrist usually complain about the following symptoms: snapping and clicking or triggering around carpal tunnel with or without mild to moderate median neuropathy. There are a total of five cases of trigger wrist: three cases of anomalous muscle belly of flexor digitorum superficialis and two cases of fibroma around flexor tendon sheath within carpal tunnel. This study reports on two of those cases: one with anomalous muscle and the other with fibroma of flexor tendon sheath. Accurate examination and proper diagnosis are mandatory to obviate improper and time-wasting treatment for patients with trigger wrist.     

Nontuberculous Mycobacterial Tenosynovitis in the Hand: Two Case Reports with the MR Imaging Findings

Nontuberculous mycobacterial infections can cause destructive tenosynovitis of the hand. We report on and discuss the clinical course and distinctive radiologic findings of two patients with hand tenosynovitis secondary to M. marinum and intracellulare infection, which are different from those of the nontuberculous mycobacterial infections reported in the previous literature.