Gross Pathology of de Quervain's Disease
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Abstract
Gross Pathology of de Quervain's Disease
Paisan Apimonbutr MD
Pruk Chaiyakit MD
Revit Tunyasuwanakul MD
Chalermsak Sriworakun MD
Department of Orthopedic Surgery, BMA Medical College and Vajira Hospital
Objective: To study the gross pathology of the first extensor compartment of the wrist in de Quervrain's disease.
Study design: Descriptive study.
Setting: Department of Orthopedic Surgery, BMA Medical College and Vajira Hospital.
Subjects: Seventy-five wrists in 73 patients were oprated upon for de Quervain's disease from January 1998 to June 2003.
Methods: The gross pathology of the first extensor compartment of the wrist was identified and recorded during operation for anatomical variation, thickening of fibrous roof, synovitis and the present of the cyst upon the fibrous roof. The data were collected and analyzed.
Main outcome measures: The amount and percentage of gross pathologic fining of de Quervain's disease.
Results: The anatomical variations discovered in the sample were; 18 wrists (24%) presented with single compartments, 23 wrists (30.67%) with incomplete septum, and 34 wrists (45.33%) were found to have a complte septum. The thickening of the fibrous roof was found in 56 wrists (74.67%). Synovitis was found in 20 wrists (26.67%) and 9 wrists (12%) were found to have contained cysts.
Conclusion: This study revealed three types of anatomical variation of the first compartment of the wrist, seven patterns of the relation between thickening of fibrous roof causing stenosis and anatomical variation of the first extensor compartment of the wrist. Synovitis and the present of the cyst upon the fibrous roof were found. The understanding and knowledge of the gross pathology can be applied both in the conservative and surgical approaches in the treatment of de Quervain's disease.
Key words: de Quervain's disease, pathology, tenosymovitis, anatomical variations, first extensor compartment of the wrist
Vajira Med J 2003 ; 47 : 167 - 175