Traumatic tendovaginitis of the fifth dorsal compartment of the wrist

Drury, Brett

doi:10.1097/00006534-196012000-00022

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“…7 It is also seen in the second ( intersection syndrome 8 ), third (extensor pollicis longus syndrome), fourth (extensor indicis proprius syndrome 9 ), and the fifth compartments. 10,11 In this study, the authors present cases without RA having tenosynovitis of fourth compartment as it has been reported in a few studies.…”

Section: Discussionmentioning

confidence: 82%

Surgical Treatment of Tenosynovitis of Extensor Tendons of Fourth Compartment of Wrist in Nonrheumatoid Patients—A Case Series of 10 Patients in India

Mahajan

Palange

Pawar

et al. 2019

Journal of Hand and Microsurgery

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Purpose Proliferative tenosynovitis of the extensor tendons is a very common painful wrist condition that can occur both in presence and absence of rheumatoid arthritis (RA). This study aims to evaluate a series of patients without RA, having extensor tendon tenosynovitis, its pathology, and results of surgical treatment. Materials and Methods A consecutive series of 10 patients without RA, having tenosynovitis of fourth extensor compartment were treated surgically and evaluated in the study. All patients were operated upon by a single surgeon, and intraoperative specimens were sent for histopathologic evaluation by a single pathologist. The functional outcome of the patients was evaluated by comparing the post- and preoperative wrist extension. Results All patients presented with painful mass over dorsum of the wrist, overlying the fourth extensor compartment. On clinical examination, there was severe limitation of active wrist extension with extended fingers and improvement in wrist extension on flexing the fingers. All patients had significant improvement in wrist extension after surgery. The histopathologic examination of the intraoperative samples revealed similar findings of tenosynovitis in all cases, which was different than that seen in RA. Conclusion This study reveals a distinct tenosynovitis in a group of patients without RA resembling traumatic tenosynovitis on histopathologic examination. Radiologic and intraoperative findings reveal presence of nodular mass in the affected tendon due to proliferative tenosynovitis, which blocks effective proximal excursion of the tendon, leading to decreased wrist extension. This study shows that surgical treatment in the form of tenosynovectomy gives excellent relief to these patients. Type of Study This is a Level IV, therapeutic study.

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Section: Discussionmentioning

confidence: 82%