Anatomical variations in the tendon sheath of the first compartment

Abstract

Using Hiranuma's classification, we carefully examined anatomical variations in the first compartments of 246 human wrist joints from 124 cadavers. Morphological examinations were conducted to determine the number of accessory tendons and the existence of dissepiments for the extensor pollicis brevis (EPB) and abductor pollicis longus (APL) tendons. Anatomical variations of EPBs and APLs were grouped together by type, and appearance ratios were calculated based on Hiranuma's classification. Of the 246 wrist joints, 156 were categorized as normal type (63.4%), 57 as complete dissepiment type (23.2%), 22 as incomplete dissepiment type (8.9%), and 11 as EPB-lacking type (4.5%). Accessory tendons were identified in both the EPB and the APL tendons of most cadavers, and the incidence of dissepiment in tendon sheaths was approximately 33%. Sixty-six of the 193 wrist joints (34.2%) showed equal numbers of right and left accessory tendons. However, the number of EPB accessory tendons was higher than in previous studies, and in all cases some kind of dissepiment was observed in the APL and EPB. The number of EPB and APL accessory tendons showed no clear differences by gender, age, or right and left specificity.

The anatomy of the fibrous and osseous components of the first extensor compartment of the wrist: a cadaveric study

“…We also observed that the frequencies of complete and incomplete septa were 44.4 and 55.5 %, respectively. Previous studies stated frequencies of a complete and incomplete septum as 23.2-53.5 % and 8.9-47 %, respectively [9,12,13,16,21]. Our results were coherent with the literature.…”

“…A limitation of our study was our relatively small sample size in regard to previous cadaveric studies [9,12,16,21]. A second limitation was that once we opened the extensor sheath, it was impossible for us to evaluate the inner morphometry of the 1stEC.…”

Anatomical variation of abductor pollicis longus in Indian population

“… 1 Multiple tendinous insertion of APL has been reported by many authors. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 The anatomical variation may remain asymptomatic or may present with painful conditions like de Quervain tenosynovitis (DQT). 2 5 6 19 The treatment of such condition in severe cases involves either an injection therapy or surgical decompression of the first extensor compartment.…”

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

“…The number of tendon slips on the APL side detected with US correlated with type of subcompartmentalization, was recorded as complete or distal incomplete ( 14,15 ) ( Fig 1 ). Complete subcompartmentalization was defi ned as the APL and EPB each running in a separate subcompartment at the level of distal radius, just after the crossover to the second extensor compartment.…”

“…In their large-scale anatomic study, Motoura et al ( 15 ) showed that anatomic variation in the fi rst compartment was as follows: normal type of de Quervain disease (Hiranuma type I) in 63.4% of cases, complete septation (Hiranuma type II) in 23.2%, incomplete septation (Hiranuma type III) in 8.9%, and EPB lacking type of de Quervain disease (Hiranuma type IV) in 4.5%. A study of 300 cadaveric wrists by Jackson et al ( 4 ) showed a 40% incidence of subcompartmentalization within the fi rst compartment, with one-third of subcompartmentalization (18%) being incomplete .…”