Compartmental reconstruction for de Quervain stenosing tenosynovitis

Abstract

We describe a new surgical technique for the treatment of de Quervain tenosynovitis, which consists of lengthening the first dorsal compartment without disruption of continuity and without using a suture. Our results in 12 wrists operated on in 10 patients indicated complete relief of symptoms. The advantages of the technique include: simplicity, restoration of normal anatomy, and prevention of complications (scarring, adhesions, and subluxation of tendons).

Long-term results of surgical release of de Quervain’s stenosing tenosynovitis

“…In 1981, Belsole [2] reported 36 complications in 19 patients after release of the first extensor compartment for de Quervain disease. Of these 36 complications, eight were related to subluxation of the tendon, eight to injury of the nerve, and seven to inadequate decompression [2,6]. As a sequel, several authors proposed compartmental reconstruction which should prevent subluxation of tendons of the first compartment [2,6,9,11,12].…”

“…Of these 36 complications, eight were related to subluxation of the tendon, eight to injury of the nerve, and seven to inadequate decompression [2,6]. As a sequel, several authors proposed compartmental reconstruction which should prevent subluxation of tendons of the first compartment [2,6,9,11,12]. A septum between the abductor pollicis longus tendon and the extensor pollicis brevis (EPB) tendon in the first extensor compartment is frequently encountered during surgical treatment of de Quervain's disease.…”

“…The management of DD is nonoperative in the first instance, but surgery should be considered if conservative measures implemented for four to six months fail [3]. Release of the first dorsal compartment by simple incision [6] for chronic de Quervain tenosynovitis is considered a simple procedure. However, its complications include volar subluxation of abductor pollicis longus and extensor pollicis brevis, radial sensory nerve injury including scarring and adhesions of the nerve, and inadequate decompression and reflex sympathetic dystrophy [6].To our knowledge there are no reports on long-term results of surgical release of DD.…”

“…Release of the first dorsal compartment by simple incision [6] for chronic de Quervain tenosynovitis is considered a simple procedure. However, its complications include volar subluxation of abductor pollicis longus and extensor pollicis brevis, radial sensory nerve injury including scarring and adhesions of the nerve, and inadequate decompression and reflex sympathetic dystrophy [6].To our knowledge there are no reports on long-term results of surgical release of DD. We present the long-term results of operative treatment of DD performed by a single surgeon.…”

Functional outcome of surgically treated De Quervain's tenosynovitis

“…Altough surgical release of first dorsal compartment with a simple incision is considered to be a simple procedure there are complications which include permanent damage to the radial sensory nerve with adhesions and scarring, inadequate decompression and development of complex regional pain syndrome which may trouble the patient more than the primary disease itself. 6 We present results and functional outcome of cases of de Quervains tenosynovitis. …”