The Fourth-Compartment Syndrome: Its Anatomical Basis and Clinical Cases

Hayashi, Hiroyuki; Kojima, Tadao; Fukumoto, Keizo

doi:10.1055/s-1999-13495

Cited by 25 publications

(19 citation statements)

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“…This may result in a so called "fourth compartment" syndrome, causing increased compartment pressure and either direct or indirect compression of the posterior interosseus nerve. 11,15) Pain may also occur secondary to chronic denervation. 7,9,12) Physical exam may delineate a firm, fusiform mass most prominent during wrist flexion and finger extension whereas a pure dorsal wrist ganglion would project solely with wrist flexion.…”

Section: Discussionmentioning

confidence: 99%

Dorsal Wrist Ganglion Associated with Extensor Digitorum Brevis Manus: Case Report and Review of the Literature

Feintisch

Datiashvili

2017

J Hand Surg Asian-Pac Vol

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Aberrant accessory muscles are rare entities in the hand. The extensor digitorum brevis manus (EDBM) muscle is amongst them and may be seen in association with dorsal ganglion cysts. Distinguishing an EDBM muscle is relevant in the diagnostic consideration of a dorsal ganglion in order to facilitate and guide its proper treatment. To date, there have been only few reports of an EDBM in association with a dorsal ganglion cyst. We report our experience with an incidental intraoperative finding of an intramuscular EDBM dorsal ganglion cyst and follow with a literature review and guide to management.

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Section: Discussionmentioning

confidence: 99%

Dorsal Wrist Ganglion Associated with Extensor Digitorum Brevis Manus: Case Report and Review of the Literature

Feintisch

Datiashvili

2017

J Hand Surg Asian-Pac Vol

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“…They speculated that adhesion of the nerve to surrounding tissue produces dorsal wrist pain. Hayashi et al 14 reported the fourth compartment syndrome. There are conditions which cause compression of the posterior interosseous nerve such as an accessory muscle.…”

Section: Discussionmentioning

confidence: 99%

Dorsal Wrist Syndrome Repair

2004

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Dorsal wrist pain with or without a palpable dorsal wrist ganglion is a common complaint. Watson developed the concept of the dorsal wrist syndrome (DWS) which is an entity encompassing pre-dynamic rotary subluxation of the scaphoid and the overloaded wrist. We reviewed 20 cases of DWS treated surgically. There were nine males (11 wrists) and nine females (nine wrists). Post-operative follow-up ranged from five to 67 months (mean, 37 months). At operation, we observed SLL tears in eight wrists and dorsal ganglia in 12 cases. Following surgery, 12 cases reported being pain free, five had mild pain, two moderate pain and one case reported severe pain. Post-operative extension/flexion was 73/70 average. Post-operative grip strength was 28 kg average. We believe that excision of the posterior interosseous nerve and the dorsal capsule including the ganglion, if present, provides pain relief in DWS.

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“…A recent article proposed the new term, "fourth-compartment syndrome," to describe chronic dorsal wrist pain of the fourth extensor compartment (26). It listed the five main causes as ganglion, EDBM, aEIP, tenosynovitis and anomaly or deformity of the carpal bones.…”

Section: Discussionmentioning

confidence: 99%

Extensor digitorum brevis manus: A case of fourth-compartment syndrome

Mahabir¹

2003

J Plast Surg

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The presence of an extensor digitorum brevis manus represents a variation of the normal anatomy of the fourth extensor compartment of the wrist. It usually presents as a swelling on the dorsum of the wrist and is often inaccurately diagnosed. An awareness of its existence and of its characteristic appearance on diagnostic imaging studies is the basis for diagnosis. Symptomatic cases require division of the extensor retinaculum or excision of the muscle, depending on subtype, while asymptomatic cases require no intervention.Key Words: Anomalous extensors; Extensor digitorum brevis manus; EDBM; Fourth-compartment syndrome Un muscle extenseur commun court des doigts : Un syndrome de la quatrième loge La présence d'un muscle extenseur commun court des doigts représente une variation de l'anatomie normale de la loge du quatrième extenseur du poignet. D'ordinaire, cette manifestation prend la forme d'un oedème du dos du poignet. Elle est souvent mal diagnostiquée. La prise de conscience de son existence et de son apparence caractéristique à la visualisation diagnostique constitue le fondement du diagnostic. En présence de cas symptomatiques, il faut diviser le ligament annulaire ou exciser le muscle, selon le sous-type, tandis que les cas asymptomatiques n'exigent aucune intervention.T he vast majority of variations of the extensor tendons of the hand are asymptomatic throughout life, but their importance in hand surgery has been documented (1-4). The variations are often found incidentally at the time of surgery and at the time of diagnostic imaging (5). On occasion they may be associated with dorsal wrist pain, but a direct correlation is often difficult in the presence of other pathology, such as a ganglion or synovitis (6-9).First described by Albinus in 1734, as "muscles extensor brevis digiti indicis vel medii" (1), the existence of this anomalous muscle was questioned owing to its infrequent clinical presentation. Various anatomical descriptions persisted, but in 1866 Macalister (10) coined the term 'extensor digitorum brevis manus' (EDBM). The first clinical correlate was reported in 1926 (11). Since then, over 100 articles have been published on the topic leading to the development of two separate classifications. With incidences reported to be between 1% and 9% (11-16), the occurrence of this muscle should not surprise the anatomist or hand surgeon. In light of the high incidence and the lack of symptomatic case reports, the majority of EDBM cases must remain asymptomatic.A case of EDBM in association with an intraosseous ganglion of the lunate as a cause of fourth-compartment syndrome is reported. A review of the literature and current imaging techniques are presented to underline the clinical implications of this anomalous extensor muscle. CASE PRESENTATIONA 36-year-old, right-hand dominant woman was referred with left wrist pain after falling on her outstretched hand. The initial swelling and pain was managed with physiotherapy. However, the pain persisted over the central dorsal aspect of the wrist and s...

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The Fourth-Compartment Syndrome: Its Anatomical Basis and Clinical Cases

Cited by 25 publications

References 0 publications

Dorsal Wrist Ganglion Associated with Extensor Digitorum Brevis Manus: Case Report and Review of the Literature

Dorsal Wrist Ganglion Associated with Extensor Digitorum Brevis Manus: Case Report and Review of the Literature

Dorsal Wrist Syndrome Repair

Extensor digitorum brevis manus: A case of fourth-compartment syndrome

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