| The Incidence of Separate Septum and Variant of the Number of Slips of APL in de Quervain’s Disease and the Usefulness of the 1,2 ICSRA in Identification of the First Extensor Compartment |
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Inhyeok Rhyou, Chaeik Chung, Bo Gun Suh, Kyungchul Kim |
| De Quervain씨병의 수술적 치료시 발견된 제1 신전구획내의 독립 구획 빈도와 장무지 외전건의 이상소견 및 제 1 신전 구획 발견에 이용된 제1,2신전구획간상지대동맥(1,2 ICSRA)의 유용성 |
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류인혁, 정재익, 서보건, 김경철 |
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| Abstract |
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eatment of de Quervain’s disease with the investigation of the incidence of the separate septum within first extensor compartment and the number of the slips of the APL. In addition, we want to report the usefulness of the 1,2 intercompartmental supraretinacular artery (1,2 ICSRA) in identification of the first extensor compartment. Methods: In 17 patients unresponsive to non-operative treatment for at least 6 months we managed surgically. Under regional anesthesia 1st extensor compartment was released as radial-based flap through 2 cm transverse skin incision proximal to radial styloid process. Patients were assessed retrospectively at average 12.2 months for pain relief, postoperative Finkelstein test, symptom of superficial radial nerve and painful palmar subluxation. The degree of pain relief was evaluated with Visual Analog Scale from no pain 0 to severe pain 10. Separate septum and slips number of APL were examined intraoperatively and the usefulness of 1,2 ICSRA was investigated. Results: Resting pain disappeared but 6 patients complained of slight negligible discomfort after strenuous exercise. Mean VAS is 0.7 (0~2). Postoperative Finkelstein test was negative in all patients. Superficial radial nerve symptom was found in one patient but disappeared within 4 weeks. The slips number of APL was more than 3 in 16 cases except one case of 2 slips. EPB was found in all cases; one case, two slips and the others one slip. Separate septum was identified in 9 cases (53%). 1,2 ICSRA was helpful to identify the first extensor compartment. Conclusion: The high number of the APL slips and the separate septum may be one cause of failed conservative treatment. The surgical result of de Quervain’s disease was acceptable based on the high patient satisfaction and low complication rate. 1,2 ICSRA can be useful guide to identification of the ulnar margin of first extensor compartment. |
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