Longitudinal Incision in Surgical Release of De Quervain Disease

Abstract

The objective of this paper is to contrast the use of a longitudinal incision in surgical decompression of De Quervain disease with a transverse incision. The advantages are ease in recognition of compartment variations and superficial branches of radial nerve and prevention of palmar tendon subluxation by permitting a more dorsal release of the compartment sheath. Since 2002, we have used a longitudinal skin incision instead of the classic transverse incision to release the first dorsal compartment.

Applied anatomy of the superficial branch of the radial nerve

“…With regard to first extensor compartment release for de Quervain's tenosynovitis, there is no clear consensus on the optimal skin incision with different authors advocating transverse (Canale, 1998), longitudinal (Adams and Stossel, 1992;Gundes and Tosun, 2005), and Z incisions (Arons, 1987). The incidence of operative damage to the SBRN ranges from 2% in large volume centers (Ta et al, 1999) to 27% in smaller units (Mellor and Ferris, 2000).…”

De Qeurvian Tenosynovitis:Cinical Outcomes of Surgical Treatment with Longitudinal and Transverse Incision

“…3,9,10 APL luxation, disfavor enlargement and adhesion of the scar. Le Viet and Lantieri reported 62 cases of De Quervain disease treated from 1983 to 1990 by the same surgeon and they found that transverse incision causes less disfavor scars.…”

“…Since then, various procedures of treatment have been reported. 3 In a study conducted by Zarin and Ahmad from 2001 to 2002, patients with De Quervain disease who did not respond to conservative treatment were operated and followed up for a minimum period of 3 months to assess their clinical outcome of procedure. The Study showed that the surgical release of the tendons had an excellent result in patients with De Quervain disease.…”

“…Since then, various procedures for treatment have been reported. 3 The advantages of longitudinal incision include easy finding of compartment variations, superficial branches of radial nerve and prevention of palmar tendon subluxation as a result of more dorsal release of the compartment sheath. 4 Using a longitudinal incision is associated with poor wound healing and damage to the terminal branches of the radial nerve.…”

Le traitement chirurgical de la ténosynovite de De Quervain chez le sportif : à propos de 22 cas

“…Le choix de la voie d'abord dépend essentiellement du chirurgien. La voie longitudinale expose mieux la branche sensitive du nerf radial tandis que la voie transversale est plus esthétique [3,14]. Lors de l'exploration chirurgicale, la recherche d'un septum intertendineux doit être systématique [5].…”