![]() ![]() 6 Despite the multitude of anatomic studies, none have addressed the need for clear anatomic landmarks required for successful injection. 6 – 10 Septations within the osteofibrous tunnel and slip multiplicity of the abductor pollicis longus (APL) have all been raised as possible causes of de Quervain's tenosynovitis, 11 or causes for failed steroid injections. Numerous anatomic and surgical studies have shown great variability in tendon structure and organization of the first dorsal compartment. In this study, we propose the use of identifiable bony landmarks in the radial aspect of the wrist for proper location of the first dorsal compartment. 5 Maintaining a high level of success with corticosteroid injections may depend on our knowledge of the first dorsal compartment for precise needle placement. Successful nonoperative management with corticosteroid injections has been demonstrated repeatedly in 50% to 80% of patients, 2 – 4 particularly in acute cases. 1 Treatment strategies include immobilization, corticosteroid injections, and operative release. Tendon entrapment of the first dorsal compartment can be managed with conservative or surgical modalities. Conclusion: The superficial bony prominences of the radial wrist can be used reliably as anatomic landmarks for the first dorsal compartment.ĭe Quervain's disease is a common cause of wrist pain and disability. The abductor pollicis longus tendon demonstrated great variability with 1, 2, 3, or 4 slips in 9%, 30%, 43%, or 26% of the specimens, respectively. A separate compartment for the extensor pollicis brevis was noted in 35% of the specimens. The distal aspect of the radial styloid was 0.3 cm distal to the distal aspect of the extensor retinaculum, and the distance between the distal aspect of the extensor retinaculum and the APL-Lister's-Scaphoid juncture was approximately 0.5 cm. Results: The average length of the extensor retinaculum from its proximal to distal extent measured approximately 2.2 cm. ![]() The compartments were also inspected for variability of the abductor pollicis longus tendon and intracompartmental septations. Methods: Thirty-two cadaveric wrists were dissected, and measurements were taken from the predetermined landmarks to the extensor retinaculum. ![]() The radial styloid, the scaphoid tubercle, and Lister's tubercle can be used as superficial landmarks for the first dorsal compartment. Objective: Knowledge of anatomic landmarks for the first dorsal compartment can assist clinicians with management of de Quervain's disease. ![]()
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