Superficial radial nerve damage due to Kirschner wiring of the radius

For displaced fractures of the radius, the use of Kirschner wires (K Wires) is accepted practice either alone or to supplement external fixation. Complications related to K wires include infection, migration and damage to tendons and nerves. We set out to investigate to incidence of superficial radial nerve damage due to radial styloid K wires. Injury to the sensory branch of the superficial radial nerve was seen in eight (20%) out of the 40 patients. K wiring is a popular technique to help maintain anatomic reduction of distal radial fractures. It has the advantage of being a semi-closed procedure, which is simple to perform. However, the morbidity of nerve damage is often underestimated and can be avoided.     

Impingement of a fibroma of the extensor tendon sheath on the extensor retinaculum

Deep lacerations to the forearm can cause impaired movement of the digits. This report describes the presentation and management of a self-harmer who presented with loss of motion of her ring finger. Surgical exploration unexpectedly demonstrated the cause to be a fibroma of the tendon sheath impinging on the extensor retinaculum. Full recovery was demonstrated at sixmonth review following removal of the lesion.     

桡神经浅支卡压征的治疗体会

本文报告用局封治疗１１例桡神经浅支卡压征。随访６个月－１年，疗效满意。其症状主要表现为：手背及前臂远段桡侧疼痛；手背桡侧感觉减退；患手握力下降；Ｔｉｎｅｌ征阳性。桡神经浅支穿出点神经是固定的，进入浅部后有一定的滑动度，长期反复活动腕关节，使桡神经浅支反复牵拉、磨擦，以致水肿纤维化、结缔组织增生造成卡压是其发病的解剖因素。     

桡神经浅支卡压征的治疗体会

本文报告用局封治疗１１例桡神经浅支卡压征。随访６个月-１年，疗效满意。其症状主要表现为：手背及前臂远段桡侧疼痛；手背桡测感觉减退；患手握力下降;Ｔｉｎｅｌ征阳性。桡神经浅支穿出点神经是固定的，进入浅部后有一定的滑动度，长期反复活动腕关节，使桡神经浅支反复牵拉、磨擦，以致水肿纤维化、结缔组织增生造成卡压是其发病的解剖因素。     

Fibroma of tendon sheath located within the ankle joint capsule

We report a very rare case of fibroma of the tendon sheath arising from the anteromedial ankle joint capsule, with no apparent connection to any tendon in the area, found in a 58-year-old patient complaining of progressive local swelling. This uncommon tumor has its usual localization in tendon sheaths, is extremely rare in joint capsules, and has never been described in this location previously. MRI showed nonuniform low signal intensity in T1- and T2-weighted images and high intensity in STIR images. The mass was completely excised by open surgery. Histopathological analysis later confirmed the diagnosis of a fibroma of the tendon sheath.     

血源性腱鞘结核1例

患者，男，25岁，1998年3月被玻璃割伤右手，致右中、环指伸指肌腱断裂，伤后在我院行清创肌腱缝合，伤口I期愈合，伸指功能恢复如初，术后5个月发现右手背原伤处出现包块，以后逐渐增大并向腕部延伸，既往无结核病史及结核病人接触史。     

Multifocal giant cell tumors of tendon sheath along a single tendon: A case report with review of literature

The giant cell tumor of tendon sheath (GCTTS) or nodular tenosynovitis arises as discrete solitary nodule in the tendon sheath near joints of toes and fingers. Multifocal giant cell tumor of tendon sheath is a rare entity, of which the etiology is not yet fully understood and it is different from diffuse type of GCTTS. Diffuse type of GCTTS occurs around large joints having a main mass from which a small satellite nodule may arise. Multifocal GCTTS along a single tendon is a more rare entity. Herein, we describe a case of multifocal GCTTS along the tendon sheath of flexor digitorum profundus tendon of index finger. The patient was managed by surgical excision of the tumor swellings with no recurrence at two years follow up.     

Posterior interosseous nerve compression syndrome following distal biceps brachii tendon rupture: an unusual sequel

We present an unusual case of a carpenter who had posterior interosseous nerve compression syndrome post-traumatic biceps brachii tendon rupture. The symptomatic presentation was confirmed by nerve conduction studies. Such a complication of biceps brachii tendon rupture has not been reported so far.     

前臂深屈肌腱腱鞘囊肿卡压尺神经1例

正患者,男,56岁,司机。因"左肘部疼痛伴左手4、5指麻木不适1个月"收住我院。入院症见:左前臂尺侧酸困、胀痛不适,左环、小指感觉麻木伴屈肘加剧。查体:屈腕、屈指功能正常,拇指内收正常。环、小指不能并拢。夹纸试验阳性。未出现爪形手。小鱼际萎缩。感觉障碍以左环、小指掌背侧明显。Tinel征阳性。第1背侧骨间肌和小指的屈指深肌肌力Ⅳ级。Froment征阳性。屈肘试验阳性。患者既往从事驾驶工作10年余,1年前因右尺神经炎行尺神经松解前     

桡神经臂段卡压的解剖学基础

目的　研究桡神经臂段卡压综合征的解剖学因素 ,为临床诊治该病提供形态学依据。方法　对 2 0具 40侧成人上肢标本 ,肉眼观察桡神经在臂段的行径及其与周围结构的毗邻关系 ,并用游标卡尺测量数据。结果　 10 0 %的肱三头肌外侧头起始腱性部分紧贴桡神经 ,且 72 .5 %的腱性部分形成纤维弓 ,穿过该纤维弓时桡神经的周径为 [(0 .93± 0 .14 )cm , x±s,下同 ]。 77.5 %的外侧肌间隔有腱性组织包绕桡神经。 3 7.5 %的肱深动脉于肱骨内外上髁连线中点上方 (16.5 2± 1.2 4)cm处横跨桡神经。 3 5 0 %的肱肌和肱桡肌之间的纤维弓和桡神经直接接触。 7 5 %的肱肌腱性部分从前方压迫桡神经 ;2 5 %桡神经受到肱三头肌长头腱性部分的卡压 ,受压处神经变细。结论　桡神经在上臂行径中多处可受到卡压 ,卡压可来自多个方向 ,术中应尽可能松解已经存在和潜在的卡压结构。     

Two-stage tendon sheath reconstruction using sublimis tendon and silicone Penrose drain after severe purulent flexor tenosynovitis: a case report

Two-stage tendon sheath reconstruction, a method of pulley reconstruction using the sublimis tendon and a pseudosheath formed with a silicone Penrose drain wrapped around the profundus tendon, is a new technique for improving a poor functional prognosis after purulent flexor tenosynovitis.     

肘部尺神经的临床解剖学研究

目的：研究产生肘部尺神经卡压的解剖学基础。方法：观测５０侧成人尸体肘部尺神经的位置及被动屈肘时尺神经的伸长长度。临床调查并检测２００位正常人肘部尺神经的位置。结果：自肘部伸直位（０度）至完全屈肘位（１３５度），尺神经可拉长 ６．６％±０．３％（ｘ±ｓｘ自身对照，下同）；屈曲度大于 ９０度后，伸展性明显减少，为０．８％±０．１％。２００位正常人肘部尺神经半脱位发生率为９．５％（１９／２００）。结论：肘关节反复屈伸时尺神经不断被牵拉和压迫是造成肘部尺神经卡压的解剖学基础。     

全肘关节弥漫性腱鞘巨细胞瘤1例报告

患者,男性,29岁.右肘关节发现肿物8年,近2年自觉肿物缓慢生长,近3个月出现胀痛,于2008年10月2日入院.该患者干活劳累时疼痛加重,休息后可缓解,伴有功能障碍.查体:右肘关节肿胀,关节周围可触及多个大小不等的肿物,质硬、活动度差,压痛不明显,肘关节屈伸时,肿物大小有改变.     

Modified brachioradialis wrap for stabilizing the distal radioulnar joint: case report

Distal radioulnar joint (DRUJ) stability requires competent static and dynamic soft tissues. Multiple DRUJ techniques have been described in the literature. Our method is a novel modification of the Gupta method of DRUJ stabilization used in a revision reconstruction on a patient with a total wrist arthroplasty. A brachioradialis graft is harvested and tunneled through Parona’s space volar to the pronator quadratus and through the muscle body. The tendon is then brought dorsal between the radius and ulna to the dorsal side of the distal ulna and sutured to the floor of the 5th extensor compartment, as well as to the surrounding extensor reticulum ulnar to the 6th compartment with nonabsorbable sutures. Our modification of the method described by Gupta prevents ulnar subluxaton of the extensor carpal ulnaris (ECU), allows the tendon graft construct to more adequately resist volar translation of the radius, and thus acts like a leash to pull the radius dorsally to the stationary ulna. This modification gives the graft a better force vector to resist the volar translation of the distal radius. We are able to present successful 30-month follow-up of this procedure.

Electronic supplementary material

The online version of this article (doi:10.1007/s11552-015-9752-0) contains supplementary material, which is available to authorized users.     

移植部分鹅足囊修复腱鞘预防指屈肌腱粘连

目的 探讨指屈肌腱损伤修复后重建腱鞘预防肌腱粘连的手术方法.方法 对78例屈肌腱损伤患者,按手术方法的不同随机分为2组.治疗组39例指屈肌腱损伤修复后切取自体部分鹅足囊修复腱鞘,重建腱鞘的完整,使之形成一完整的闭合鞘管并注入玻璃酸钠.对照组不修复腱鞘.结果 经6～38个月临床随访,按TAM手指功能评价治疗组：优21例,良11例,中6例,差1例,优良率82.1%;对照组优良率51.3%,差异有显著性（Х^2=8.34,P=0.004）.结论 切取部分鹅足囊移植修复并应用具有营养和润滑作用的玻璃酸钠,能有效预防指屈肌腱修复后的粘连,是实用的手术方法.     

Radial nerve compression between the brachialis and brachioradialis muscles in a manual worker: a case report

We report a case of high right radial nerve palsy in which the nerve was compressed between the brachialis and brachioradialis muscles.