Anatomical variation in the first extensor compartment during treatment of De Quervain'S tenosynovitis

Abstract

Background: De Quervain's disease is ste¬nosing tenosynovitis of the abductor pollicis longus and the extensor pollicis brevis within the first extensor retinaculum compartment of the wrist. The patient usually present with clinical symptoms like pain and a painful range of motions of the thumb which occur either due to increased friction force or due to increase in contain within the compartment during the gliding of the adductor pollicis longus (APL) and the extensor pollicis brevis (EPB) first extensor compartment. Following conservative trials of rest, moist heat, NSAID, and local steroid injections, surgical release of the first compartment are effective treatment modalities for De Quervain's disease, but these even leads to failure of treatment as there may be variation on the anatomy of first extensor compartment of wrist. We had done this study to find out anatomical variation in first extensor compartment during treatment of De Quervains tenosynovitis. Method: Anatomical Variations like presence or absence of septum between APL and EPB, number of tendon slip of APL and EPB in the first extensor compartment were studied in 16 patients of dequervains tenosynovitis who underwent open surgical release as the treatment. Result: 7/16 (43.75%) of patient has partial or complete Sub compartment in the fibro-osseous tunnel and 4/16 (25%) patient has extra Abductor Pollicis Longus (APL) tendon sheath in first extensor compartment. Conclusion: We found significant increase in variation of anatomy in first extensor compartment of De Quervains tenosynovitis patient which will be for the surgeon during the surgical release of first extensor compartment.

Keywords

• anatomical variation in the first extensor compartment
• de quervain's tenosynovitis
• number of apl and extensor pollicis brevis tendons
• open surgical release