- 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.