Anatomy and Cell Biology

  • 제57권2호
  • /
  • Pages.246-255
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  • 2024
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  • 2093-3665(pISSN)
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  • 2093-3673(eISSN)
대한해부학회 (Korean Association of Anatomists)
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Relationship to the superficial radial nerve and anatomic variations of the first extensor compartment in Thai population: a basis for successful de Quervain tenosynovitis treatment

  • 투고 : 2024.01.11
  • 심사 : 2024.03.06
  • 발행 : 2024.06.30
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초록

Knowledge of the superficial radial nerve (SRN) relationship and anatomic variations of the first extensor compartment (1st EC) will contribute to a better outcome of de Quervain tenosynovitis treatment. We dissected 87 embalmed cadaveric wrists to determine the relationship of the SRN, the 1st EC length, distance from the proximal and distal 1st EC borders to radial styloid process (RSP), abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendon slip numbers, and the presence of septum. Our results revealed SRN crossing over the 1st EC in 59.5%. The lateral branch of the superficial radial nerve to the 1st EC midline in most cases (61.9%) except for one specimen, where lateral antebrachial cutaneous nerve was the closest. Distances from proximal and distal 1st EC borders to the RSP were 19.7±4.1 mm and 7.6±1.8 mm, respectively. Extensor retinaculum (ER) width over 1st EC (1st EC length) was 14.8±3.2 mm. Complete and incomplete septa were found in 17.2%, and 42.5%, respectively. The most frequent APL tendon slip number in the compartment was two in overall 47 specimens (54.0%). Almost all compartments (85 specimens; 97.7%) contained one EPB tendon slip. We detected bilateral EPB absence in one cadaver. Moreover, we recorded a tendon slip from extensor pollicis longus traveling into 1st EC bilaterally in one cadaver and observed the EPB muscle belly extension into 1st EC in 9 wrists. Awareness of 1st EC anatomic variations would be essential for successful surgical and nonsurgical outcomes.

키워드

과제정보

The authors would like to express their gratitude to those who have donated their body for medical study and research. Special thanks are extended to the technical staff of the Department of Anatomy, Faculty of Medicine, Chulalongkorn University for their support.

참고문헌

  1. Lee ZH, Stranix JT, Anzai L, Sharma S. Surgical anatomy of the first extensor compartment: a systematic review and comparison of normal cadavers vs. De Quervain syndrome patients. J Plast Reconstr Aesthet Surg 2017;70:127-31.  https://doi.org/10.1016/j.bjps.2016.08.020
  2. Currie KB, Tadisina KK, Mackinnon SE. Common hand conditions: a review. JAMA 2022;327:2434-45. Erratum in: JAMA 2023;330:772. 
  3. Ilyas AM, Ast M, Schaffer AA, Thoder J. De quervain tenosynovitis of the wrist. J Am Acad Orthop Surg 2007;15:757-64. Erratum in: J Am Acad Orthop Surg 2008;16:35A. 
  4. Larsen CG, Fitzgerald MJ, Nellans KW, Lane LB. Management of de Quervain tenosynovitis: a critical analysis review. JBJS Rev 2021;9:e21.00069. 
  5. Harvey FJ, Harvey PM, Horsley MW. De Quervain's disease: surgical or nonsurgical treatment. J Hand Surg Am 1990;15:83-7.  https://doi.org/10.1016/S0363-5023(09)91110-8
  6. Gurses IA, Coskun O, Gayretli O, Kale A, Ozturk A. The anatomy of the fibrous and osseous components of the first extensor compartment of the wrist: a cadaveric study. Surg Radiol Anat 2015;37:773-7.  https://doi.org/10.1007/s00276-015-1439-2
  7. Ilyas AM. Nonsurgical treatment for de Quervain's tenosynovitis. J Hand Surg Am 2009;34:928-9.  https://doi.org/10.1016/j.jhsa.2008.12.030
  8. McDermott JD, Ilyas AM, Nazarian LN, Leinberry CF. Ultrasound-guided injections for de Quervain's tenosynovitis. Clin Orthop Relat Res 2012;470:1925-31.  https://doi.org/10.1007/s11999-012-2369-5
  9. Gulec A, Turkmen F, Toker S, Acar MA. Percutaneous release of the first dorsal extensor compartment: a cadaver study. Plast Reconstr Surg Glob Open 2016;4:e1022. 
  10. Saaiq M. Management outcome of de Quervain's disease with corticosteroid injection versus surgical decompression. Arch Bone Jt Surg 2021;9:167-73. 
  11. Zingas C, Failla JM, Van Holsbeeck M. Injection accuracy and clinical relief of de Quervain's tendinitis. J Hand Surg Am 1998;23:89-96.  https://doi.org/10.1016/S0363-5023(98)80095-6
  12. Weller WJ. Stenosing tenosynovitis of the wrist and hand. In: Azar FM, Beaty JH, editors. Campbell's Operative Orthopaedics. 14th ed. Elsevier; 2021. p. 3850-6. 
  13. Giles KW. Anatomical variations affecting the surgery of de Quervain's disease. J Bone Joint Surg Br 1960;42-B:352-5.  https://doi.org/10.1302/0301-620X.42B2.352
  14. Leslie BM, Ericson WB Jr, Morehead JR. Incidence of a septum within the first dorsal compartment of the wrist. J Hand Surg Am 1990;15:88-91.  https://doi.org/10.1016/S0363-5023(09)91111-X
  15. Visuthikosol V, Chanyasawat S. Surgical treatment of de Quervain's diseases: a clinical review of 42 cases. J Med Assoc Thai 1988;71:637-9. 
  16. Suresh SS, Zaki H. De quervain disease: Ibri technique to avoid superficial radial nerve injury. Tech Hand Up Extrem Surg 2009;13:113-5.  https://doi.org/10.1097/BTH.0b013e31819f6cdd
  17. Arons MS. de Quervain's release in working women: a report of failures, complications, and associated diagnoses. J Hand Surg Am 1987;12:540-4.  https://doi.org/10.1016/S0363-5023(87)80204-6
  18. Huanmanop T, Agthong S, Luengchawapong K, Sasiwongpakdee T, Burapasomboon P, Chentanez V. Anatomic characteristics and surgical implications of the superficial radial nerve. J Med Assoc Thai 2007;90:1423-9. 
  19. Chhabra AB, Freilich AM. Wrist and hand. In: Miller MD, Chhabra AB, Browne JA, Park JS, Shen FH, Weiss DB, editors. Orthopaedic Surgical Approaches. 2nd ed. Elsevier; 2015. p. 105-59. 
  20. Cheong IY, Rhyu IJ, Kim KH, Chung PW, Kim D, Park BK, Kim DH. Anatomical basis for injection around first dorsal compartment of the wrist: a fresh cadaveric study. Pain Physician 2016;19:E893-900.  https://doi.org/10.36076/ppj/2016.19.E893
  21. Gurses IA, Coskun O, Gayretli O, Kale A, Ozturk A. The relationship of the superficial radial nerve and its branch to the thumb to the first extensor compartment. J Hand Surg Am 2014;39:480-3.  https://doi.org/10.1016/j.jhsa.2013.12.004
  22. Ikiz ZA, Ucerler H. Anatomic characteristics and clinical importance of the superficial branch of the radial nerve. Surg Radiol Anat 2004;26:453-8.  https://doi.org/10.1007/s00276-004-0256-9
  23. Poublon AR, Kleinrensink GJ, Kerver A, Coert JH, Walbeehm ET. Optimal surgical approach for the treatment of Quervains disease: a surgical-anatomical study. World J Orthop 2018;9:7-13.  https://doi.org/10.5312/wjo.v9.i2.7
  24. Abrisham SJ, Karbasi MH, Zare J, Behnamfar Z, Tafti AD, Shishesaz B. De qeurvian tenosynovitis: clinical outcomes of surgical treatment with longitudinal and transverse incision. Oman Med J 2011;26:91-3.  https://doi.org/10.5001/omj.2011.23
  25. Kumar K. Outcome of longitudinal versus transverse incision in de Quervain's disease and its implications in Indian population. Musculoskelet Surg 2016;100:49-52.  https://doi.org/10.1007/s12306-015-0388-6
  26. Mangukiya HJ, Kale A, Mahajan NP, Ramteke U, Manna J. Functional outcome of De Quervain's tenosynovitis with longitudinal incision in surgically treated patients. Musculoskelet Surg 2019;103:269-73.  https://doi.org/10.1007/s12306-018-0585-1
  27. Hazani R, Engineer NJ, Cooney D, Wilhelmi BJ. Anatomic landmarks for the first dorsal compartment. Eplasty 2008;8:e53. 
  28. Massaki AN, Tan J, Huang BK, Chang EY, Trudell DJ, Resnick DL. Extensor retinaculum of the wrist: gross anatomical correlation with MR imaging after ultrasound-guided tenography with emphasis on anatomical features in wrist dorsiflexion responsible for tendon impingement. Skeletal Radiol 2013;42:1727-37.  https://doi.org/10.1007/s00256-013-1739-8
  29. Sugiura S, Matsuura Y, Suzuki T, Nishikawa S, Kuniyoshi K, Ohtori S. Histological assessment of a septum in the first dorsal compartment: a fresh cadaver study. J Hand Surg Eur Vol 2019;44:805-9.  https://doi.org/10.1177/1753193419838204
  30. Leversedge FJ, Cotterell IH, Nickel BT, Crosmer M, Richard M, Angermeier E. Ultrasonography-guided de Quervain injection: accuracy and anatomic considerations in a cadaver model. J Am Acad Orthop Surg 2016;24:399-404. Erratum in: J Am Acad Orthop Surg 2016;24:565. 
  31. Abi-Rafeh J, Mojtahed Jaberi M, Kazan R, Alabdulkarim A, Boily M, Thibaudeau S. Utility of ultrasonography and significance of surgical anatomy in the management of de Quervain disease: a systematic review and meta-analysis. Plast Reconstr Surg 2022;149:420-34.  https://doi.org/10.1097/PRS.0000000000008792
  32. Sawaizumi T, Nanno M, Ito H. De Quervain's disease: efficacy of intra-sheath triamcinolone injection. Int Orthop 2007;31:265-8.  https://doi.org/10.1007/s00264-006-0165-0
  33. Kulthanan T, Chareonwat B. Variations in abductor pollicis longus and extensor pollicis brevis tendons in the Quervain syndrome: a surgical and anatomical study. Scand J Plast Reconstr Surg Hand Surg 2007;41:36-8.  https://doi.org/10.1080/02844310600869720
  34. Bonczar M, Walocha J, Pasternak A, Depukat P, Dziedzic M, Ostrowski P, Bonczar T, Warchol L, Koziej M. Anatomical variations in the first dorsal compartment of the wrist: meta-analysis. Folia Morphol (Warsz) 2023;82:766-76.  https://doi.org/10.5603/FM.a2022.0081
  35. Bahm J, Szabo Z, Foucher G. The anatomy of de Quervain's disease. A study of operative findings. Int Orthop 1995;19:209-11.  https://doi.org/10.1007/BF00185223
  36. Roy AJ, Roy AN, De C, Banerji D, Das S, Chatterjee B, Halder TC. A cadaveric study of the first dorsal compartment of the wrist and its content tendons: anatomical variations in the Indian population. J Hand Microsurg 2012;4:55-9.  https://doi.org/10.1007/s12593-012-0073-z
  37. Coskun O, Ok F, Sahin B, Gurses IA. First extensor compartment morphology and clinical significance: a cadaver series study. Anat Cell Biol 2023;56:328-33.  https://doi.org/10.5115/acb.23.008
  38. Shiraishi N, Matsumura G. Anatomical variations of the extensor pollicis brevis tendon and abductor pollicis longus tendon--relation to tenosynovectomy. Okajimas Folia Anat Jpn 2005;82:25-9.  https://doi.org/10.2535/ofaj.82.25
  39. Mahakkanukrauh P, Mahakkanukrauh C. Incidence of a septum in the first dorsal compartment and its effects on therapy of de Quervain's disease. Clin Anat 2000;13:195-8.  https://doi.org/10.1002/(SICI)1098-2353(2000)13:3<195::AID-CA6>3.0.CO;2-V
  40. Gousheh J, Yavari M, Arasteh E. Division of the first dorsal compartment of the hand into two separated canals: rule or exception? Arch Iran Med 2009;12:52-4. 
  41. Nayak SR, Hussein M, Krishnamurthy A, Mansur DI, Prabhu LV, D'Souza P, Potu BK, Chettiar GK. Variation and clinical significance of extensor pollicis brevis: a study in South Indian cadavers. Chang Gung Med J 2009;32:600-4.  https://doi.org/10.1007/s00276-009-0526-7
  42. Opreanu RC, Wechter J, Tabbaa H, Kepros JP, Baulch M, Xie Y, Lackey W, Katranji A. Anatomic variations of the first extensor compartment and abductor pollicis longus tendon in trapeziometacarpal arthritis. Hand (N Y) 2010;5:184-9.  https://doi.org/10.1007/s11552-009-9234-3
  43. Sugiura S, Matsuura Y, Kuniyoshi K, Nishikawa S, Toyooka T, Mori C, Suzuki T. Anatomic study of the first extensor compartment and the relationship between the extensor tendon width and its distal insertion. Surg Radiol Anat 2017;39:1223-6.  https://doi.org/10.1007/s00276-017-1867-2
  44. Ravi PK, Tewari J, Mishra PR, Tripathy SK, Nanda SN, Gantaguru A. Variations of extensor pollicis brevis tendon in Indian population: a cadaveric study and review of literature. J Clin Orthop Trauma 2019;10:278-81.  https://doi.org/10.1016/j.jcot.2018.02.008
  45. Pahlavansabagh A, Soleimani M, Ghaznavi A, Roshanipour M, Yousefi F, Taheri SN. Prevalence of septated first dorsal compartment among Iranian patients with de Quervain tenosynovitis. Med J Islam Repub Iran 2022;36:130. 
  46. Chang CY, Kheterpal AB, Vicentini JRT, Huang AJ. Variations of anatomy on MRI of the first extensor compartment of the wrist and association with DeQuervain tenosynovitis. Skeletal Radiol 2017;46:1047-56.  https://doi.org/10.1007/s00256-017-2639-0
  47. Rosa RC, de Oliveira KM, Leo JA, Elias BA, dos Santos PR, de Santiago HA. Anomalous bilateral contribution of extensor pollicis longus and muscle fusion of the first compartment of the wrist. Rev Bras Ortop 2016;51:235-8. https://doi.org/10.1016/j.rbo.2015.04.030