AI Article Synopsis

  • - The study investigates why de Quervain's disease, a form of stenosing tenosynovitis occurring at the wrist, happens more in the dorsal part of the first extensor compartment compared to the palmar part, focusing on anatomical differences.
  • - Researchers analyzed 35 wrists from 23 cadavers, finding that the palmar septum was thicker and more connected to surrounding muscles than the dorsal septum, which is more fragile.
  • - The findings suggest that the robust structure of the palmar septum may contribute to fewer symptoms of de Quervain's disease, which could enhance the understanding and treatment of this condition.

Article Abstract

Background: The first extensor compartment of the wrist is known as a frequent site of stenosing tenosynovitis, referred to as de Quervain's disease. De Quervain's disease occurs more frequently in the dorsal part of the first extensor compartment than in the palmar part; however, the anatomical reason why the dorsal part is worse remains poorly elucidated. This study clarified the morphological differences between the dorsal and palmar parts by examining their relationship with the surrounding structures.

Methods: In this study, a total of 35 wrists from 23 Japanese cadavers were used. Twenty-five wrists were randomly assigned for macroscopic analysis, and the remaining 10 wrists were used for histological analysis.

Results: The palmar septum of the first extensor compartment was connected to the brachioradialis tendon and superficial head of the pronator quadratus and was histologically stout compared to the dorsal septum. Despite several anatomical variations, such as the septum between the abductor pollicis longus/extensor pollicis brevis and the multiple tendons of these muscles, the aforementioned characteristics of the fibrous sheath in the first extensor compartment were identical in all specimens.

Conclusion: In contrast to the fragile structure of the dorsal septum, the stout structure of the palmar septum could be related to the low occurrence of symptoms of de Quervain's disease. The present results could play a role in revealing the pathogeny and establish the precise treatment for de Quervain's disease and provide an anatomical basis for kinesiological/biomechanical studies.

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Source
http://dx.doi.org/10.1016/j.aanat.2024.152228DOI Listing

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