Abstract

JIMENEZ-MUNOZLEDO, Gustavo; LOPEZ-INFANTE, Raúl  and  SASTRE-ORTIZ, Nicolás. Presence of septum in the first extensor compartment of the wrist and relation with recurrence in De Quervain's disease. Cir. plást. iberolatinoam. [online]. 2016, vol.42, n.3, pp.265-270. ISSN 1989-2055.

Background and Objectives. The presence of a septum in the first extensor compartment of the wrist is an anatomic variant and also a major cause of persistent or recurrent pain after a specific corrective surgery for a patient with De Quervain's disease. This is why it's very important to keep in mind this condition and determine its incidence in our population, as in medical literature there are no similar results in the frequency of presentation of this septum. Methods. We conduct an anatomical study in 10 Mexican cadavers, both hands, to identify the structure of the first extensor compartment and document the presence of septum. As in the Plastic and Reconstructive Surgery Service of the Hospital General de México is a routine practice to look for this septum, we review our service records between March 2010 and March 2013. Results. In the anatomical study on cadavers, 9 had septum: 3 on the right hand, 1 on the left hand, and 5 bilaterally; only 1 body had no septum. In our records we found 52 patients: 4 (7.7%) males and 48 (92.3% (48 females, age ranged between 34 to 75 years (mean of 55.1 +/ -10.2). In this group, 39 had right tenosynovitis (75%), and 13 had left tenosynovitis (25%) with no bilateral cases. In all of them routine revision of the first compartment of the wrist was made during surgery looking for septum, that was present in 47 (90.38%). All the patients followed postoperative follow up on the day 7, 14, 30, 60, 230 and 360, without cases of recurrence of the De Quervain's disease. Finally, Fisher exact test was performed between the group of cadavers and patients obtaining a p of 0.988 which reflects that there is no statistically significant difference between groups. Conclusions. From the clinical review we determine that making a systematic review of the first extensor compartment of the wrist and a proper release, we can solve without recurrence De Quervain's disease. From the anatomic study we obtain and estimated incidence of septum presence in the Mexican population. Hand surgeon must keep on mind the possible presentation of this anatomical varian that in our serie appeared in 90.38% of the cases, in order to get a correct solution of patients' symptomatology and avoid recurrence in De Quervain's disease.

Keywords : De Quervain's disease; Tenosynovitis; Hand; Wrist; Hand Anatomy.

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