Clinical Sign for Missed Decompression of a Separate Extensor Pollicis Brevis Compartment in de Quervain’s Disease

2017 ◽  
Vol 49 (03) ◽  
pp. 185-187
Author(s):  
Niels Benatar
Keyword(s):  
Clinical Sign ◽  
Revisional Surgery ◽  
Persistent Pain ◽  
Previous Surgery ◽  
De Quervain’S Disease ◽  
Longus Tendon ◽  
Abductor Pollicis Longus ◽  
Extensor Pollicis Brevis ◽  
First Extensor Compartment ◽  
Extensor Compartment

AbstractPersistent pain despite previous surgery for de Quervain’s disease might be due to an overlooked septum between the abductor pollicis longus tendon slips and the extensor pollicis brevis tendon, or an overlooked completely separate compartment for the extensor pollicis brevis tendon alone. In both of these instances, extension of the MP joint of the thumb against resistance elicits pain at the distal level of the first extensor compartment of the wrist. When this sign is positive, revisional surgery and decompression of the remaining septum or separate compartment is indicated.

Abductor Pollicis Longus Tendon Rupture in De Quervain’s Disease

2006 ◽  
Vol 31 (1) ◽  
pp. 72-75 ◽  
Author(s):  
A. YUEN ◽  
C. J. COOMBS
Keyword(s):  
Tendon Rupture ◽  
Relevant Literature ◽  
Diagnosis And Treatment ◽  
De Quervain’S Disease ◽  
Longus Tendon ◽  
Abductor Pollicis Longus ◽  
First Extensor Compartment ◽  
Extensor Compartment

De Quervain’s disease is a stenosing tenovaginitis involving the first extensor compartment of the wrist. The similarity of its symptomatology to a number of other conditions and its controversial aetiology are only a few of the barriers which often delay its diagnosis and treatment. We report the first two cases in the literature of abductor pollicus longus tendon rupture in patients with De Quervain’s disease who had been treated with conservative methods. The relevant literature is reviewed.

Excision of aberrant abductor pollicis longus tendon slips for decompression of de Quervain’s disease

2011 ◽  
Vol 36 (5) ◽  
pp. 379-382 ◽  
Author(s):  
M. Okada ◽  
J. E. Kutz
Keyword(s):  
Surgical Procedure ◽  
Tendon Transfer ◽  
Loss Of Function ◽  
De Quervain’S Disease ◽  
Extensor Tendons ◽  
Longus Tendon ◽  
Abductor Pollicis Longus ◽  
First Extensor Compartment ◽  
Extensor Compartment ◽  
Multiple Slips

Release or excision of the first extensor compartment is a commonly performed surgical procedure to treat de Quervain’s disease. This technique can potentially cause palmar subluxation of the extensor tendons. The abductor pollicis longus (APL) tendon has multiple slips which can be used as a resource for tendon transfer without loss of function. The technique described in this paper is decompression of the first extensor compartment by excision of an aberrant APL tendon slip without releasing the first extensor compartment. This technique was used in 24 wrists in 21 patients, and outcome assessed. All our patients had relief from pain and tenderness. No patients needed immobilization and none had subluxation of the extensor tendons. Patients without workers’ compensation returned to work 15 days after surgery.

Accuracy of intrasheath injection techniques for de Quervain’s disease: a cadaveric study

2012 ◽  
Vol 37 (2) ◽  
pp. 155-160 ◽  
Author(s):  
C. Mirzanli ◽  
K. Ozturk ◽  
C. Z. Esenyel ◽  
S. Ayanoglu ◽  
Y. Imren ◽  
...  
Keyword(s):  
Cadaveric Study ◽  
De Quervain’S Disease ◽  
Abductor Pollicis Longus ◽  
Extensor Pollicis Brevis ◽  
First Extensor Compartment ◽  
Injection Techniques ◽  
Extensor Compartment

The purpose of this study was to assess the accuracy of injections of dye into the first extensor compartment of the wrist using three different techniques in 150 wrists in 75 fresh cadavers. To compare injections, 50 wrists from 25 cadavers were used for each technique. After the injections, the first extensor compartment was dissected and the dispersion of dye around the abductor pollicis longus and extensor pollicis brevis tendons was investigated. In 72 % of all the wrists, acrylic dye was dispersed into one compartment containing both the abductor pollicis longus and extensor pollicis brevis tendons, but in 28% of the wrists there was a separate compartment for extensor pollicis brevis and dye entered only one of the compartments (14% for each compartment). For accurate injections, we think the injections should be made separately over the two tendons, to allow for the possibility of a septum within the compartment.

scholarly journals Anatomic Variations of the First Extensor Compartment and Abductor Pollicis Longus Tendon in Trapeziometacarpal Arthritis

Hand ◽  
2009 ◽  
Vol 5 (2) ◽  
pp. 184-189 ◽  
Author(s):  
Razvan C. Opreanu ◽  
John Wechter ◽  
Hazem Tabbaa ◽  
John P. Kepros ◽  
Michelle Baulch ◽  
...  
Keyword(s):  
Anatomic Variations ◽  
Longus Tendon ◽  
Abductor Pollicis Longus ◽  
First Extensor Compartment ◽  
Extensor Compartment

The Relation Between Primary Osteoarthritis of the Trapeziometacarpal Joint and Supernumerary Slips of the Abductor Pollicis Longus Tendon

2002 ◽  
Vol 27 (3) ◽  
pp. 238-241 ◽  
Author(s):  
C. U. SCHULZ ◽  
H. ANETZBERGER ◽  
M. PFAHLER ◽  
M. MAIER ◽  
H. J. REFIOR
Keyword(s):  
Thenar Eminence ◽  
Trapeziometacarpal Joint ◽  
Longus Tendon ◽  
Abductor Pollicis Longus ◽  
Primary Osteoarthritis ◽  
First Extensor Compartment ◽  
Trapeziometacarpal Joint Osteoarthritis ◽  
Extensor Compartment ◽  
The Right

We have studied whether accessory abductor pollicis longus slips inserting into the thenar eminence or trapezium influence the incidence and severity of trapeziometacarpal joint osteoarthritis. The right first extensor compartment of 73 cadavers was dissected and trapeziometacarpal degeneration was graded macroscopically. The main abductor pollicis longus tendon which inserted at the metacarpal base was accompanied by supernumerary APL slips in 96% of cases. Thenar or trapezial slips occurred frequently but coexisted in only one case. The incidence of trapeziometacarpal arthritis was not influenced by the number of accessory slips or whether they inserted onto the thenar eminence or the trapezium.

De Quervain’s Disease

2000 ◽  
Vol 25 (1) ◽  
pp. 65-69 ◽  
Author(s):  
N. R. M. KAY
Keyword(s):  
De Quervain’S Disease ◽  
Factors Associated ◽  
The Poor ◽  
First Extensor Compartment ◽  
Extensor Compartment

The basic anatomy of the first extensor compartment is presented with a review of the pathology of de Quervain’s stenosing tenovaginitis. The results in 100 medicolegal cases of de Quervain’s disease are analysed and reasons are sought for the poor results. A review of the known factors associated with the causation of de Quervain’s disease is presented with recommendations about the management of this condition.

Tendon Interposition Arthroplasty of the First Carpo-Metacarpal Joint

1988 ◽  
Vol 13 (4) ◽  
pp. 421-425
Author(s):  
A. WEILBY
Keyword(s):  
Radial Nerve ◽  
Interposition Arthroplasty ◽  
Nerve Lesions ◽  
Flexor Carpi Radialis ◽  
Abductor Pollicis Longus ◽  
Slight Pain ◽  
First Extensor Compartment ◽  
Full Power ◽  
Extensor Compartment ◽  
Tendon Interposition

After removal of the trapezium, imbrication of abductor pollicis longus and fixing it with a strip of flexor carpi radialis tendon, we obtained a stable arthroplasty having three quarters of normal mobility and half to full power. Of the first 100 operated thumbs, 15 patients had slight pain on heavy use; the rest were painfree. Three patients had radial nerve lesions with minor complaints. Seven patients developed de Quervain’s syndrome and two had rupture of abductor pollicis longus; these complications have since been avoided by routinely splitting the first extensor compartment. Four cases with unstable joints required further surgery, and one joint became stiff due to extra-articular conditions.

scholarly journals Variation of abductor pollicis longus tendons in cadavers

2018 ◽  
Vol 4 (3) ◽  
pp. 417
Author(s):  
R. K. Jain ◽  
Nihit Mantri ◽  
P. Mandlecha
Keyword(s):  
Treatment Failure ◽  
Indian Population ◽  
Incidental Finding ◽  
Metacarpal Bone ◽  
Extensor Retinaculum ◽  
Abductor Pollicis Longus ◽  
Muscle Insertion ◽  
First Extensor Compartment ◽  
Stenosing Tenosynovitis ◽  
Extensor Compartment

<p class="abstract"><strong>Background:</strong> First extensor compartment of the wrist comprises of abductor pollicis longus and extensor pollicis brevis. It helps in movement and stabilization of thumb. Variations in the number of tendons of APL muscle may be asymptomatic and often incidental finding. Stenosing tenosynovitis of the first dorsal compartment of the wrist or de Quervains disease is a commonly encountered debilitating condition of the wrist.</p><p class="abstract"><strong>Methods:</strong> This cadaveric study was done on 40 forearms in 20 cadavers available in Department of anatomy and forensic medicine at our institute. The muscles of extensor compartments were dissected, extensor retinaculum split over first extensor compartment, tendons of APL exposed. Study period from February-2017 to February-2018.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 6 female and 14 male cadavers. The APL muscle was found with a single tendon in 2, double in 30, triple in 8. There were variations in the insertion of the APL tendon as well. In all hands, the APL tendon had insertion into the first metacarpal bone and in 20 hands (50%), it had second insertion into the trapezium.</p><p class="abstract"><strong>Conclusions:</strong> Variation of APL muscle insertion in the Indian population and two or more tendinous slips attached commonly to the first metacarpal base and the trapezium may be the cause of treatment failure in DQT and cause of Trapeziometacarpal arthritis. Further studies needs to be done for further evaluation.</p>

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