Anatomical Variations of the First Dorsal Compartment in de Quervain Tenosynovitis.

Background: De Quervain tenosynovitis of the wrist is a common pathology. The primary aim of this study is to determine the prevalence of extensor pollicis brevis and abductor pollicis longus (APL) anatomical variations in association with de Quervain tenosynovitis. The secondary aim was to compare additional patient-specific factors associated with de Quervain tenosynovitis.
Methods: This retrospective study included 172 patients with de Quervain tenosynovitis who underwent first dorsal compartment release and 179 patients with thumb carpometacarpal (CMC) arthritis who underwent thumb CMC arthroplasty between August 1, 2007, and May 1, 2022. The CMC group was chosen as the control group because the study surgeons perform APL suspensionplasty as the primary procedure for thumb CMC arthritis, allowing for a comparison group without de Quervain tenosynovitis. Exclusion criteria included patients undergoing revision surgery, patients undergoing thumb CMC procedure other than APL suspensionplasty, and patients with both CMC and first dorsal compartment diagnoses. Demographics, clinical variables, and intraoperative findings were collected through retrospective chart reviews.
Results: Patients in the de Quervain tenosynovitis group tended to be younger (51 years, range: 23-92 years vs 63 years, range: 28-85 years), women (86.1% vs 77.1%), and more commonly of African American or black race (15.7% vs 3.9%) and Asian race (5.2% vs 0%). There was a higher prevalence of tendon subcompartments (79.1% vs 64.2%), but fewer number of APL slips (38.3% vs 20.7% 2 or fewer slips) seen in the de Quervain tenosynovitis group.
Conclusion: Anatomical variation exists between patients with and without de Quervain tenosynovitis. The presence of tendon subcompartments but not an increased number of tendon slips is associated with de Quervain tenosynovitis.
Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: B.E. is a paid consultant of Synthes, owns stock in Johnson & Johnson and Pfizer, and is a board member for AAOS and American Society for Surgery of the Hand. D.Z. receives research support from Akcea Therapeutics unrelated to this project. He has also received a speaker honorarium from Alnylam Pharmaceuticals, is a committee member of the American Society for Surgery of the Hand, and is on the editorial board for The Journal of Hand Surgery (Asian-Pacific Volume). P.B. is on the editorial board for Journal of Hand Surgery and Techniques in Hand and Upper Extremity. C.L. and S.M. declare that they have no conflict of interest.