[Enlargement plasty of the first dorsal compartment for the surgical treatment of de Quervain's tenosynovitis].
OBJECTIVE
Reliable reduction of pain, observance of anatomical variations, avoidance of complications.


METHODS
Failure of conservative treatment, clinically obvious diagnosis, positive Finkelstein test (pathognomonic).


METHODS
Previous splitting of the retinaculum of the first dorsal compartment, uncertainty of diagnosis.


METHODS
Skin incision with protection of the branches of the superficial radial nerve, exposure of the first dorsal compartment, w-shaped incision and preparation of the retinaculum lobes, exposure of all tendons, inspection of the whole compartment and possible anatomic variations. Loose adaptation of the lobes, irrigation, hemostasis, skin closing.


METHODS
Consequent immobilization in a thumb cast for a total of 3 weeks (+ 3 weeks optional depending on load/profession). Sutures removed after 2 weeks, then the patient can start mobilization exercises (without the splint) after 3 weeks.


RESULTS
Between August 2005 and July 2007, 38 patients (40 wrists) were operated without complications. No tendon subluxation/dislocation, one wrist with persistent slightly positive Finkelstein test, in all other cases complete relief of the symptoms. All patients would elect to repeat the surgery.
Orthopädische Klinik, Luzerner Kantonsspital, 6000, Luzern, Schweiz. judith.bering@luks.ch
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J
Bering
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D
Bignion
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P
Kurzen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000209:etiology / Q000517:prevention & control*; D001178:Arthroplasty / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D013717:Tenosynovitis / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D014955:Wrist Joint / Q000601:surgery*; D055815:Young Adult