Ultrasound Measurements of the First Extensor Compartment: Determining the Transection Limits for Ultra-minimally Invasive Release of De Quervain Tenosynovitis

Hand ◽  
2019 ◽  
pp. 155894471987343
Author(s):  
Logan McCool ◽  
Brionn Tonkin ◽  
Danqing Guo ◽  
Danzhu Guo ◽  
Alexander Senk
Keyword(s):  
Average Length ◽  
Short Axis ◽  
Anatomical Dissection ◽  
Compressive Neuropathy ◽  
First Extensor Compartment ◽  
Fresh Frozen ◽  
De Quervain ◽  
Tunnel Syndrome ◽  
Extensor Compartment ◽  
Guo Technique

Background: De Quervain syndrome is the second most common compressive tendinopathy. Although the length of the first extensor compartment (FEC) has been studied previously, there is no documented reported comparison study of short-axis and long-axis sonographic measurements. The thread technique, or Guo Technique, has been applied to carpal tunnel syndrome, trigger finger, and superficial peroneal compressive neuropathy. To perform this procedure, it is critically important to accurately identify the boundaries for transection. Methods: Twenty-one fresh frozen cadaver upper extremities were examined under ultrasound to determine the length of the extensor retinaculum (ER) over the FEC. Using the sonographic landmarks, the ERs were measured in short axis and long axis over their proximal to distal margins and from the distal margins to the distal edges of the radial styloids. These sonographic measurements were then compared with gross anatomical measurements. Results: The short-axis sonographic measurement of the ER on average was 22.53 mm (95% confidence interval [CI] = 20.79-24.05 mm). The long-axis sonographic measurement of the ER on average was 15.65 mm (95% CI = 13.70-17.78 mm). The average length of the ER by gross anatomical dissection was 22.40 mm (95% CI = 21.15-23.51 mm). Conclusions: The short axis is not significantly different from the gross anatomical measurement; however, the long axis is significantly lower than the gross anatomical measurement. The results support the idea that the short axis is more accurate than the long axis.

Histological assessment of a septum in the first dorsal compartment: a fresh cadaver study

2019 ◽  
Vol 44 (8) ◽  
pp. 805-809
Author(s):  
Shiro Sugiura ◽  
Yusuke Matsuura ◽  
Takane Suzuki ◽  
Satoru Nishikawa ◽  
Kazuki Kuniyoshi ◽  
...  
Keyword(s):  
Cadaver Study ◽  
Extensor Retinaculum ◽  
Histological Assessment ◽  
De Quervain’S Disease ◽  
Histological Features ◽  
The Third ◽  
Fresh Cadaver ◽  
First Extensor Compartment ◽  
Fresh Frozen ◽  
Extensor Compartment

Resistance of de Quervain’s disease to conservative treatment has been associated with an intertendinous septum in the first compartment; little is known about the histological features of such a septum. This study aimed to examine the intertendinous septum histologically and note its variations. After dissecting the first extensor compartment of 24 hands from 12 fresh frozen cadavers, the presence of any intertendinous septa was determined. The length of the extensor retinaculum and intertendinous septum was measured; histological findings of the first compartment with or without septa were studied and compared with those of the third/fourth compartment. Intertendinous septa were observed in 12 of 24 wrists. Histological assessment of the intertendinous septum revealed tissue similar in composition to the retinaculum observed between the third and fourth compartments.

de Quervain Disease: US Identification of Anatomic Variations in the First Extensor Compartment with an Emphasis on Subcompartmentalization

Radiology ◽  
2011 ◽  
Vol 260 (2) ◽  
pp. 480-486 ◽  
Author(s):  
Soo-Jung Choi ◽  
Jae Hong Ahn ◽  
Young-Jun Lee ◽  
Dae Sik Ryu ◽  
Jong Hyeog Lee ◽  
...  
Keyword(s):  
Anatomic Variations ◽  
First Extensor Compartment ◽  
De Quervain ◽  
Extensor Compartment ◽  
De Quervain Disease

Omega “Ω” Pulley Plasty for Surgical Management of DeQuervain’s Disease

2018 ◽  
Vol 23 (02) ◽  
pp. 170-175 ◽  
Author(s):  
Joseph Bakhach ◽  
Bachar Chaya ◽  
Nazareth Papazian
Keyword(s):  
Clinical Trial ◽  
Adhesion Formation ◽  
Styloid Process ◽  
Alternative Procedure ◽  
Periosteal Flap ◽  
Extensor Tendons ◽  
First Extensor Compartment ◽  
De Quervain ◽  
Extensor Compartment ◽  
Surgical Option

Background: DeQuervain tenosynovitis, refractory to medical conservative treatment, has been traditionally treated by a simple division of the pulley, a procedure associated with several complications. Many authors attempted to prevent these complications by describing techniques of pulley reconstruction after its release necessitating suturing the different flaps and subsequently promoting extensor tendons adhesions. The authors present an alternative procedure for the first extensor compartment pulley decompression: “Omegaplasty”. Methods: 25 Patients with 29 DeQuervain tenosynovitis cases were enrolled in a prospective, nonrandomized clinical trial from 2012 to 2016. At enrollment they were offered the option of Omegaplasty as a surgical treatment modality for their cases. The procedure is based on liberating the anterior attachment of the pulley from the anterior lip of the styloïd process while respecting its continuity with the periosteal flap as well as promoting expansion of the tunnel volume. All operated patients were evaluated using the “Opposition Kapandji Score”. Results: The authors present the results of 29 different “Omegaplasty” procedures. Based on the Kapandji opposition score, twenty cases scored 10/10 while the remaining nine cases yielded an 8/10 score each. Conclusions: The described technique is simple, reliable and respects the extensor tendons gliding physiology and biodynamics. By preserving the anatomical continuity of the first extensor compartment pulley at the wrist, the risk of adhesion formation is reduced. The preliminary results are encouraging and provide the “Ω” plasty the potential to be considered as a surgical option for treatment of De Quervain Tenosynovitis.

scholarly journals De Quervain`s disease: evaluation by high resolution ultrasonography

2017 ◽  
Vol 5 (9) ◽  
pp. 4093
Author(s):  
Abhishek Das ◽  
Prabhu B. J.
Keyword(s):  
High Resolution ◽  
Common Finding ◽  
Extensor Retinaculum ◽  
De Quervain’S Tenosynovitis ◽  
First Extensor Compartment ◽  
De Quervain ◽  
Extensor Compartment ◽  
High Resolution Ultrasonography ◽  
A Prospective Study

Background: De Quervain's tenosynovitis is a stenosing tenosynovitis of the first extensor compartment of wrist and leads to wrist pain and impaired function of wrist and hand.  The aim of this study is to evaluate the role of high resolution ultrasonography in diagnosing suspected cases of de Quervain’s tenosynovitis and also to evaluate the role of high resolution ultrasonography in detecting the anatomical variants of the first extensor compartment which are predisposing conditions for de Quervain’s tenosynovitis.Methods: A prospective study of 15 consecutive cases who were referred with clinical diagnosis of de Quervain`s disease was done with ultrasonography in the department of Radio-diagnosis and findings were carefully analysed.Results: Thickened extensor retinaculum over the first extensor compartment was found in all the cases. Mean thickness of the thickened retinaculum is 1.65 mm. In 60% of cases multiple slips of APL tendon were found.Conclusions: From the study, we conclude that extensor retinaculum thickening is a common finding in de Quervain`s disease.

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.

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.

scholarly journals ENMG PROFILE OF PATIENTS WITH HAND PAIN COMPLAINTS

2020 ◽  
Vol 8 (1) ◽  
pp. 243-249
Author(s):  
Shahdevi NK ◽  
Kandhisa ◽  
H Machlusil ◽  
Neila R
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Neuromuscular Disorders ◽  
Daily Practice ◽  
Study Data ◽  
Research Subjects ◽  
Old Patients ◽  
Hand Pain ◽  
De Quervain ◽  
Tunnel Syndrome

Introduction: Hand pain is a complaint that often found in daily practice. Electroneuromyography (ENMG) examination has pivotal role neuromuscular disorders in hand pain. This study aims to determine ENMG profile of patients with hand pain complaints also its characteristics. Methods: This research is a descriptive observational study. Data were obtained by interviewing technique conducted in neurology polyclinic General Hospital of Dr. Saiful Anwar Malang (RSSA), comprises patient characteristic and their ENMG summaries. There were a total of 58 patients with hand complaint that fulfilled inclusion criteria. ENMG was conducted to all research subjects. Results: For 10 months (April 2017 – December 2017) there were 58 patients complained of hand pain, comprised 50 new patients (86%) and 8 old patients (13%). A total of 41 subjects (71%) were women and 17 subjects (29%) were men with complaints of unilateral hand 44 (76%) and bilateral 14 (24%) subjects. The major age group was 45-55 years (70%). The average occupation that experienced by patients was housewife (63%). Patients came with paresthesia as their most complaints (60%) with positive Tinnel sign found in 62% of patients and hypertension 34% and DM 24% as comorbids. ENMG was conducted to all patients with carpal tunnel syndrome (CTS) 44 patients (75%), polyneuropathy 6 patients (10%), de Quervain 6 patients (10%) as results. Conclusion: The most ENMG results of patients with hand pain complaints is carpal tunnel syndrome.

scholarly journals Review of temporal bone dissection teaching: how it was, is and will be

2009 ◽  
Vol 124 (2) ◽  
pp. 119-125 ◽  
Author(s):  
A P George ◽  
R De
Keyword(s):  
Virtual Reality ◽  
Temporal Bone ◽  
Three Dimensional ◽  
Review Of The Literature ◽  
Anatomical Dissection ◽  
Pubmed Database ◽  
Fresh Frozen ◽  
History Of ◽  
Temporal Bone Anatomy ◽  
Three Dimensional Models

AbstractObjective:We aimed to review the history of anatomical dissection, and to examine how modern educational techniques will change the way temporal bone dissection is taught to otolaryngology trainees.Method:Review of the literature using Medline, Embase and PubMed database searches.Results:Temporal bone anatomy has traditionally been taught using cadaveric specimens. However, resources such as three-dimensional reconstructed models and ‘virtual reality’ temporal bone simulators have a place in educating the otolaryngology trainee.Conclusion:We should encourage the use of fresh frozen cadaveric temporal bone specimens for future otologists. Artificial three-dimensional models and virtual reality temporal bone simulators can be used to educate junior trainees, thus conserving the scarce resource of cadaveric bones.

Sign in / Sign up

Export Citation Format

Share Document