Anatomical variations in the first extensor compartment of the wrist. A clinical and anatomical study.

Jackson, William T.; Viegas, Steven F.; Coon, Thomas M.; Stimpson, K D; Frogameni, Anthony D.; Simpson, J. M.

doi:10.2106/00004623-198668060-00016

Cited by 170 publications

(145 citation statements)

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“…We observed this structure in 71% of asymptomatic contralateral wrists of the patients with the septum and in 15% of those without the septum. The bilaterality of the septum based on sonographic examination was similar to results in a previous anatomic study using cadavers [6], which suggested sonography may detect the septum in the asymptomatic individuals. However, the accuracy of sonographic examination in this population has not been determined because no gold standard measure such as surgery could be used for comparison.…”

Section: Discussionsupporting

confidence: 85%

“…Investigations of cadaveric wrists have revealed the presence of an intracompartmental septum in the first extensor compartment in 47% (range, 20%-78%) of wrists on average, and this prevalence is greater (average, 59%; range, 44%-91%) in the wrists of patients with de Quervain's disease [3,5,6,9,13,[16][17][18][19]21]. When we combined data from previous studies to calculate the relative risk conferred by an intracompartmental septum to the development of de Quervain's disease, we found a relative risk of 1.40 (95% CI, 1.19-1.65) (Tables 1, 2).…”

Section: Discussionmentioning

confidence: 99%

“…When only one tendon was seen after opening the first extensor compartment, the decision was straightforward. However, when two tendons were seen, the above criteria were strictly followed so as not to miss the presence of the intracompartmental septum in a rare case such as both tendons being EPB tendons and the volar wall being the intracompartmental septum [6]. After irrigation with normal saline, the skin was closed with 4-0 absorbable suture in a subcuticular fashion.…”

Section: Methodsmentioning

confidence: 99%

“…The intracompartmental septum reportedly occurs in 44% to 91% of patients with de Quervain's disease [3,5,6,9,13,16,18,19] although it is seen in only 20% to 40% of cadavers [3,4,6,[8][9][10][11]13]. Two previous studies have directly compared the prevalences of an intracompartmental septum in cadavers and patients with de Quervain's disease, and both reported a higher prevalence of an intracompartmental septum in patients [6,9]. Furthermore, several studies have suggested those with a separate septum are at higher risk for nonoperative treatment failure [5,9,18,19] and even surgical failure [12,14].…”

mentioning

confidence: 99%

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Sonographic Identification of the Intracompartmental Septum in de Quervain's Disease

Kwon

Choi

Koh

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background The intracompartmental septum in the first extensor compartment in patients with de Quervain's disease has been associated with disease development and prognosis. However, with the exception of surgical exploration, there is no way of detecting the septum. Questions/Purposes We evaluated the accuracy of sonography for identifying the intracompartmental septum in the first extensor compartment in patients with de Quervain's disease using surgical findings as the reference standard. Patients and Methods We performed surgical release of the first extensor compartment in 43 wrists of 40 patients who were unresponsive to nonoperative treatment. In each case, a sonographic evaluation was performed before surgery by a radiologist and the sonographic and surgical findings were compared. Results Sonography identified the intracompartmental septum in 19 of the 19 septum-present wrists and absence of the septum in 23 of the 24 septum-absent wrists. The sensitivity of sonography was 100% (95% confidence interval, 80%-100%), its specificity 96% (95% confidence interval, 78%-100%), accuracy 98% (95% confidence interval, 87%-100%), positive predictive value 95% (95% confidence interval, 74%-100%), and negative predictive value 100% (95% confidence interval, 83%-100%). Sonography also identified septum-like structures in 15 of 37 (41%) asymptomatic contralateral wrists.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Sonographic Identification of the Intracompartmental Septum in de Quervain's Disease

Kwon

Choi

Koh

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…Two anatomic variations involving this fibro-osseous tunnel have been widely reported in anatomic and surgical studies: a vertical septum, which splits the compartment into two distinct subcompartments, and the presence of multiple slips instead of a single APL tendon. [5][6] Anatomic variations may be a causative factor in patients with de Quervain's disease. A vertical septum splitting the compartment seems to predispose to local tendon friction.…”

Section: Discussionmentioning

confidence: 99%

De Quervain`s disease: evaluation by high resolution ultrasonography

Das

Prabhu

2017

Int J Res Med Sci

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Background: De Quervain's tenosynovitis is a stenosing tenosynovitis of the first extensor compartment of wrist and leads to wrist pain and impaired function of wrist and hand. The aim of this study is to evaluate the role of high resolution ultrasonography in diagnosing suspected cases of de Quervain’s tenosynovitis and also to evaluate the role of high resolution ultrasonography in detecting the anatomical variants of the first extensor compartment which are predisposing conditions for de Quervain’s tenosynovitis.Methods: A prospective study of 15 consecutive cases who were referred with clinical diagnosis of de Quervain`s disease was done with ultrasonography in the department of Radio-diagnosis and findings were carefully analysed.Results: Thickened extensor retinaculum over the first extensor compartment was found in all the cases. Mean thickness of the thickened retinaculum is 1.65 mm. In 60% of cases multiple slips of APL tendon were found.Conclusions: From the study, we conclude that extensor retinaculum thickening is a common finding in de Quervain`s disease.

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A variation in the organization of abductor pollicis longus

Fabrizio

Clemente

1996

Clin. Anat.

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Anatomical variations in the first extensor compartment of the wrist. A clinical and anatomical study.

Cited by 170 publications

References 0 publications

Sonographic Identification of the Intracompartmental Septum in de Quervain's Disease

Sonographic Identification of the Intracompartmental Septum in de Quervain's Disease

De Quervain`s disease: evaluation by high resolution ultrasonography

A variation in the organization of abductor pollicis longus

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