Summary
We have studied the anatomical findings at operation on 67 patients with De Quervain's disease, 5% of whom had bilateral lesions, compared with published series of cadaveric dissections. There was division with a septum in the extensor compartment in 60%. The abductor pollicis longus had more than one tendon in 76% and extensor pollicis brevis was represented by a single tendon in 96%. If there was an anatomical predisposition to the condition, more cases would have been bilateral. A septum and a crowded compartment are mainly responsible for the failure of steroid injections.
Résumé
Les auteurs ont comparé les constatations anatomiques dans 70 cas de ténosynovites de De Quervain opérés, avec les études anatomiques, pour déterminer s'il existe une prédisposition anatomique au niveau du premier compartiment des extenseurs. 5% des 67 patients ont eu une intervention bilatérale. 60% avaient un compartiment double avec cloisonnement. Plus d'un tendon APL était présent dans 76%. Les séries anatomiques publiées dans la littérature montrent un taux de 73% de disposition anatomique symétrique et 40% de compartiment unique. Les interventions bilatérales devraient donc être observées en cas de prédisposition. Par contre, la dédoublement du premier compartiment et l'encombrement par des tendons multiples peuvent être la cause de l'échec du traitement par infiltration de corticoïdes.
Similar content being viewed by others
References
Anderson BC, Manthey R, Brouns MC (1991) Treatment of De Quervain's tenosynovitis with corticosteroids. Arthrit Rheum 34: 793–798
Brunelli GA and Brunelli GR (1991) Anatomical study of distal insertion of the abductor pollicis longus. Concept of a new musculo-tendinous unit: the abductor carpi muscle. Ann Hand Upper Limb Surg 10: 569–576
Dawson S, Barton N (1986) Anatomical variations of the extensor pollicis brevis. J Hand Surg [Br] 11: 378–381
Foucher G (1989) Les tendinites de la main et du poignet. Pathologie tendineuse de la main. Masson 147–155
Giles KW (1960) Anatomical variations affecting the surgery of De Quervain's disease. J Bone Joint Surg [Br] 42: 352–355
Jackson WT, Viegas SF, Coon TM, Stimpson KD, Frogameni AD, Simpson JM (1986) Anatomical variations in the first extensor compartment of the wrist. J Bone Joint Surg [Am] 68: 923–926
Keon-Cohen B (1951) De Quervain's disease. J Bone Joint Surg [Br] 33: 96–99
Lacey T, Goldstein LA, Tobin CE (1951) Anatomical and clinical study of the variations in the insertions of the abductor pollicis longus tendon associated with stenosing tendovaginitis. J Bone Joint Surg [Br] 33: 347–350
Leao L (1958) De Quervain's disease — a clinical and anatomical study. J Bone Joint Surg [Am] 40: 1063–1070
Loomis LK (1951) Variations of stenosing tenosynovitis at the radial styloid process. J Bone Joint Surg [Am] 33: 340–346
Minamikawa Y, Peimer CA, Cox WL, Sherwin FS (1991) De Quervain's Syndrome — Surgical and anatomical studies of the fibroosseous canal. Orthopedics 14: 545–549
Revol L, Lantieri L, Loy S, Guerin Surville H (1991) Vascular anatomy of the forearm muscles. Plast Reconstr Surg 88: 1026–1033
Witt J, Pess G, Gelberman RH (1991) Treatment of De Quervain tenosynovitis. J Bone Joint Surg [Am] 73: 219–221
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Bahm, J., Szabo, Z. & Foucher, G. The anatomy of de Quervain's disease. International Orthopaedics 19, 209–211 (1995). https://doi.org/10.1007/BF00185223
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00185223