title: Surgical release of the first extensor compartment for refractory de Quervain's tenosynovitis: surgical findings and functional evaluation using DASH scores.
abstract: BACKGROUND
  Few studies have evaluated surgical outcomes in patients with refractory de Quervain's disease using validated outcome measures. We assessed the clinical outcomes of dorsal release of the first extensor compartment for the treatment of de Quervain's disease using the disabilities of the arm, shoulder and hand (DASH) score.
  
  
  METHODS
  From October 2003 to May 2009, we retrospectively evaluated 33 patients (3 men and 30 women) who underwent surgical treatment for de Quervain's disease. All patients had a positive Finkelstein test and localized tenderness over the first dorsal compartment. All operations were performed under local anesthesia. A 2-cm-long transverse skin incision was made over the first extensor compartment and the dorsal retinaculum covering the extensor pollicis brevis was incised longitudinally. Preoperative and postoperative clinical evaluation included the use of DASH score, Finkelstein test, and visual analogue scale (VAS) score.
  
  
  RESULTS
  In 18 patients (55%), the extensor pollicis brevis tendon compartment was separated from the abductor pollicis longus compartment. Eight patients had intracompartmental ganglia in the extensor pollicis brevis subcompartment. All patients except one had negative sign on Finkelstein test at the last follow-up. The average VAS score decreased from 7.42 preoperatively to 1.33 postoperatively (p < 0.05), and DASH score was improved from 53.2 to 3.45 (p < 0.05). There were no postoperative complications such as subluxation of the tendon of the first dorsal compartment or injury to the sensory branch of the radial nerve.
  
  
  CONCLUSIONS
  Intracompartment ganglia and the separate septum of extensor pollicis brevis are often related to de Quervain's disease. The release of the first extensor compartment for refractory de Quervain's disease resulted in good clinical outcomes with minimal morbidity.
authors.affiliation: Department of Orthopaedic Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Hyun-Joo
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Daegu Park Hospital, Daegu, Korea.
authors.forename: Poong-Taek
authors.initials: PT
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Fatmawati National General Hospital, Jarkarta, Indonesia.
authors.forename: Iman Widya
authors.initials: IW
authors.lastname: Aminata
authors.affiliation: Department of Orthopaedic Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Han-Pyo
authors.initials: HP
authors.lastname: Hong
authors.affiliation: Department of Orthopaedic Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Jong-Pil
authors.initials: JP
authors.lastname: Yoon
authors.affiliation: Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Jeon
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D053684:De Quervain Disease / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012008:Recurrence; D012189:Retrospective Studies
keywords: De Quervain disease; Disability evaluation; Function; Surgery; Tenosynovitis