Ĭorticosteroid injection is the first line treatment for de Quervain disease with an initial response rate ranging from 50% to 83%. It has been shown that the septum plays an important role in the development of de Quervain disease.
The septum has been classified into the complete type and the incomplete type. The previously reported incidence of the first extensor compartment septum ranged from 34.6% to 72%, which may completely or incompletely divide the compartment into 2 subcompartments. Multiple APL tendon slips ranging from 3 to 14 have been reported in up to 89% subjects. The anatomical variations of the first extensor compartment include the number of the APL tendon slips and the presence of a septum. Understanding the anatomy of the first extensor compartment is essential for successful treatment of de Quervain disease. These pathological changes restricted the sliding of APL and EPB tendons in the first extensor compartment, which results in pain. The pathological examination of de Quervain disease, although also known as de Quervain tenosynovitis, shows no signs of inflammation, but signs of degenerative changes, such as mucoid degeneration, fibrocartilage metaplasia, mucopolysaccharide deposition, and neovascularization. De Quervain disease is the most common disease involving the hand extensor tendons, with a general incidence of 0.5% in males and 1.3% in females. The abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons are contained in the first extensor compartment. Exposure to 5 mm proximal to the radial styloid process can avoid the overlook of subcompartment and achieve adequate decompression of the first extensor compartment. Injection at 5 mm proximal to the radial styloid process has a great chance of delivering the steroids into both subcompartments. The incidence of a septum in the first extensor compartment is approximately 50%. There was no significant difference in the septum length between males and females (5.3 ± 2.3 vs 4.8 ± 1.1 mm, P =. 21), and type III was found in 11 sides in males (45.8%) versus 9 sides in females (56.25%, P =.
733), type II was found in 6 sides in males (25%) versus 1 side in females (6.25%, P =. Type I compartment was found in 7 sides in males (29.2%) versus 6 sides in females (37.5%, P =. The anatomical variations of the first extensor compartment were classified into 3 types. The septum length was recorded with the radial styloid process as the reference point. The presence of a septum in the first extensor compartment was examined. This study aimed to examine the incidence and length of the first extensor compartment septum.įorty sides of the wrists in 20 cadavers were used. The presence of a septum in the first extensor compartment is closely associated with the pathophysiology of de Quervain disease, and affects the efficacy of corticosteroid injection and surgical release. The work cannot be changed in any way or used commercially without permission from the journal.
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This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The authors declare that they have no competing interests. All authors read and approved the final manuscript. JQX and OYY interpreted the patient data. DDepartment of Obstetrics, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.Ĭorrespondence: Ji-Xia Wu, Department of Obstetrics, Affiliated Hospital of Qingdao University, No.16, Jiangsu Road, Qingdao, Shandong 266003, China (e-mail: ).Ībbreviations: APL = abductor pollicis longus, EPB = extensor pollicis brevis.Īuthorship: ZYG performed or participated the study.
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