掌腱膜桡侧挛缩的临床特点与治疗

目的探讨掌腱膜桡侧挛缩的病变特点和临床疗效。方法对8例因掌腱膜桡侧挛缩行手术治疗的病例进行回顾性研究。8例的病变均位于虎口和大鱼际区域，表现为皮肤纠集、结节和条索，很少影响拇指的活动范围。均手术切除局部的掌腱膜条索。7例患者获得随访，平均随访25．1个月；1例失访。结果掌腱膜桡侧挛缩多与尺侧挛缩并发，手术治疗总体疗效较好，仅有1例复发。术后病理证实切除的组织为挛缩的掌腱膜。结论掌腱膜桡侧挛缩的发病部位集中于第一掌指关节的掌侧、大鱼际尺侧、虎口部位和大鱼际桡侧，未见累及指问关节，手术治疗可取得良好效果。

Clinical features and treatment of Dupuytren's disease on radial part of the hand

Objective To explore the clinical features and clinical outcome of Dupuytren's disease on the radial part of the hand. Methods Eight cases of Dupuytren's disease on the radial part of the hand were studied retrospectively. All of them were located on the first web space and thenar eminence region, demonstrating tangled skin, nods and cords. Range of motion of the thumb was slightly impacted. The local strip of palmar aponeurosis was excised. Seven cases were followed up with an average of 25.1 months. One case was lost in follow-up.Results The contracture of the palmar aponeurosis in the radial part of the hand often occurred in combination with that in the ulnar side. The general results were satisfactory. Only 1 case recurred. The interphalangeal joint was seldom involved. Pathological results revealed that the excised tissue was contracture of palmar aponeurosis. Conclusion The typical locations of Dupuytren's disease on the radial part are the first metarcarpophalangeal joint at the palmar side, the thenar eminence at the ulnar side, the first web space and the thenar eminence at the radial side. The interphalangeal joint is rarely affected. Good results can be achieved after aponeurectomy.