De Quervain tenosynovitis: New enlargement plasty of the first dorsal compartment Anatomical study and clinical retrospective study

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Pablo Valle
Fernando Cervigni
Marcelo Racca
Laura Frutos
Belén Grasso

Abstract

Objective: To establish the anatomical feasibility of the first dorsal compartment (FDC) enlargement and to report our clinical experience with this new technique compared with the traditional release.
Materials and Methods: Anatomical study of 12 cadaver wrists to corroborate first compartment enlargement and its relationship to the sensitive branch of the radial nerve. Clinical retrospective study of patients who had undergone surgery between 2014 and 2019 due to De Quervain tenosynovitis (DQT)refractory to nonsurgical management, over 18 years of age, with no previous surgical history and a 12-month minimum follow-up. The 22-patient series was divided into two groups: enlargement (Group A) and simple release (Group B). Average ages were 47 years (Group A) and 50 years (Group B). Subjective outcome was evaluated by the visual analogue scale (VAS) for pain, the Quick-DASH score, and the Patient Satisfaction Questionnaire Short Form (PSQ-18). Objective outcome was evaluated by goniometry and dynamometry tests.
Results: The anatomical study proved the increase of the FDC laxity and its close relationship to thesensitive branch of the radial nerve. The clinical study follow-up periods were of 24 months in Group A and 50 months in Groups B. Average VAS scores were 0.5/10 in Group A and 1/10 in Group B). Satisfaction index was 97% in both groups. Quick-DASH scores, and goniometry and dynamometry tests yielded no significant differences.
Conclusions: The new enlargement plasty of the FDC for the surgical treatment of DQT in this anatomical and clinical study proved to be a reproducible and effective technique.
Key words: De Quervain; enlargement; sensitive branch of the radial nerve.Level of Evidence: III
 
 
 

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How to Cite
Valle, P., Cervigni, F., Racca, M., Frutos, L., & Grasso, B. (2020). De Quervain tenosynovitis: New enlargement plasty of the first dorsal compartment. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 85(4S), S19-S25. https://doi.org/10.15417/issn.1852-7434.2020.85.4S.1174
Section
Clinical Research
Author Biographies

Pablo Valle, Upper Limb Reconstructive and Hand Surgery Sector, Department of Orthopedics and Traumatology, Hospital Privado Universitario de Córdoba (Córdoba, Argentina)

Upper Limb Reconstructive and Hand Surgery Sector, Department of Orthopedics and Traumatology,Hospital Privado Universitario de Córdoba (Córdoba, Argentina)

Fernando Cervigni, Upper Limb Reconstructive and Hand Surgery Sector, Department of Orthopedics and Traumatology, Hospital Privado Universitario de Córdoba (Córdoba, Argentina)

Upper Limb Reconstructive and Hand Surgery Sector, Department of Orthopedics and Traumatology,Hospital Privado Universitario de Córdoba (Córdoba, Argentina)

Marcelo Racca, Upper Limb Reconstructive and Hand Surgery Sector, Department of Orthopedics and Traumatology, Hospital Privado Universitario de Córdoba (Córdoba, Argentina)

Upper Limb Reconstructive and Hand Surgery Sector, Department of Orthopedics and Traumatology,Hospital Privado Universitario de Córdoba (Córdoba, Argentina)

Laura Frutos, Upper Limb Reconstructive and Hand Surgery Sector, Department of Orthopedics and Traumatology, Hospital Privado Universitario de Córdoba (Córdoba, Argentina)

Upper Limb Reconstructive and Hand Surgery Sector, Department of Orthopedics and Traumatology,Hospital Privado Universitario de Córdoba (Córdoba, Argentina)

Belén Grasso, Upper Limb Reconstructive and Hand Surgery Sector, Department of Orthopedics and Traumatology, Hospital Privado Universitario de Córdoba (Córdoba, Argentina)

Upper Limb Reconstructive and Hand Surgery Sector, Department of Orthopedics and Traumatology,Hospital Privado Universitario de Córdoba (Córdoba, Argentina)

References

1. Finkelstein H. Stenosing tendovaginitis at the radial styloid process. J Bone Joint Surg Am 1930;12(3):509-540.

2. Moore JS. De Quervain’s tenosynovitis: Stenosing tenosynovitis of the first dorsal compartment. J Occup Environ Med 1997;39:990-1002. https://doi.org/10.1097/00043764-199710000-00011

3. Altay M, Erturk C, Isikan U. De Quervain’s disease treatment using partial resection of the extensor retinaculum: A short-term results survey. Orthop Traumatol Surg Res 2011;97(5):489-93. https://doi.org/10.1016/j.otsr.2011.03.015

4. Ramesh R, Britton JM. A retinacular sling for subluxing tendons of the first extensor compartment. A case report. J Bone Joint Surg Br 2000;82(3):424-5. https://doi.org/10.1302/0301-620x.82b3.9867

5. Perno-Ioanna D, Papaloïzos M. A comprehensive approach including a new enlargement technique to prevent
complications after De Quervain tendinopathy surgery. Hand Surg Rehabil 2016;35(3):183-9.
https://doi.org/10.1016/j.hansur.2016.03.002

6. Rogozinski B, Lourie G. Dissatisfaction after first dorsal compartment release for De Quervain tendinopathy.
J Hand Surg Am 2016;41:117-9. https://doi.org/10.1016/j.jhsa.2015.09.003

7. Abrams R, Brown R, Botte M. The superficial branch of the radial nerve: An anatomic study with surgical
implications. J Hand Surg Am 1992;17(6):1037-41. https://doi.org/10.1016/s0363-5023(09)91056-5

8. Kilic A, Kale A, Usta A, Bilgili F, Yabukcuoglu Y, Sökücü S. Anatomic course of the superficial branch of the
radial nerve in the wrist and its location in relation to wrist arthroscopy portals: A cadaveric study. Arthroscopy
2009;25(11):1261-4. https://doi.org/10.1016/j.arthro.2009.05.015

9. Jordaan P, Kang Wang C, Yew Ng C. Management of painful cutaneous neuromas around the wrist. Orthop Trauma 2017;30:1-6. https://doi.org/10.1016/j.mporth.2017.05.006