- Anatomy:
- transports
APL &
EPB tendons;
- these tendons represent the radial border of the
anatomic snuff box;
- when pts thumb is extended, you can distinguish between the tendons as they exit the tunnel;
- near insertions of tendons, distal to the tunnel, the EPB lies on ulnar side of the APL;
- in general, the surgeon should expect to find anatomic variants in this area,
- often there are multiple slips of the
APL and complete compartmentalization of the
EPB;
- Clinical Significance:
- it is the site for stenosing tenosynovitis (
DeQuervain's disease) in which inflammation of
synovial lining of tunnel narrows tunnel opening & results in pain when tendons move;
-
cross over syndrome:
- the tendons of the first compartment may cross over the tendons of the second compartment (ECRL/B),
just proximal to the extensor retinaculum;
- the resultant tenosynovitis occurs mainly in the second compartment, and steroid injections into this
compartment relieve most symptoms;
Treatment of de Quervain tenosynovitis. A prospective study of the results of injection of steroids and immobilization in a splint.
Common variations of the radial wrist extensors.
JA Albright.
J. Hand Surgery. Vol 3. 1978. p 134.
