Anatomic variants of the first extensor compartment of the wrist in patients with De Quervain's tenosynovitis. In vivo anatomical evaluation and patient characterization
DOI:
https://doi.org/10.58814/01208845.84Keywords:
De Quervain Disease, Tendinopathy, Hand, AnatomyAbstract
Introduction: The first extensor compartment of the wrist includes the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons. Although anatomical variations have been reported in terms of the number of APL and EPB tendons and the presence of an intercompartmental septum, there are currently no in vivo studies on these variations in Colombian patients, at least none published in biomedical journals.
Objective: To describe the anatomical variations of the first extensor compartment of the wrist in Colombian patients with De Quervain's tenosynovitis undergoing surgery to release said compartment, to characterize these patients, and to determine the relationship between the presence of these variations and demographic and clinical variables.
Methodology: Retrospective case series of 163 patients with De Quervain's tenosynovitis who underwent surgical release of the first extensor compartment of the wrist (164 operated hands) in a tertiary care clinic of Medellín (Colombia) between September 2008 and December 2022. Data were collected based on the review of the medical records and operative notes. A bivariate analysis (Chi-square test of independence) was performed to explore the relationship between the clinical and demographic variables considered and the presence of anatomical variants of the first extensor compartment and variant type.
Results: The median age of the patients was 54 years (min: 18 – max: 90 years) and 88.4% were women. Anatomical variants of the first extensor compartment of the wrist were found in 63.4% of the operated hands, the most frequent being multiple APL tendons (45.7%), followed by the presence of a septum (43.9%). A statistically significant relationship was observed between the postpartum period and the presence of a septum (p=0.029) and accessory APL tendons (p=0.016).
Conclusion: In the present study, anatomical variants of the first extensor compartment of the wrist were observed in a high proportion of the patients with de Quervain's tenosynovitis evaluated, with the presence of accessory APL tendons and intercompartmental or aberrant septum being the most frequent variations.
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