Anatomical variations in the first dorsal compartment of the wrist: meta-analysis.

Abstract

The first dorsal compartment of the wrist includes tendons of abductor pollicis longus (APL) and extensor pollicis brevis (EPB). However, many studies have showed multiple anatomical variations including anomalies in the number of both APL and EPB tendons and presence of intercompartmental fibro-osseous septum. Unfortunately, studies describing those variations are not consistent, hence, the aim of this study was to provide most accurate data about these anatomical variations in the population, using systematic review and meta-analysis. For this purpose, PubMed, Scopus, Web of Science, Embase and a number of minor online libraries were searched. Articles which included exact data about the number of APL or EPB tendons or a presence of intercompartmental septum were qualified for a more precise evaluation. Therefore, out of 1629 studies initially evaluated, 68 were finally included in this meta-analysis. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 5229 studied wrists have been included in this study. Double APL and single EPB are the most common variations of tendons in the first dorsal compartment, both in cadavers and patients with de Quervain's disease, with no statistically significant differences between those two groups. Presence of intercompartmental fibro-osseus septum is much more common in patients with de Quervain's disease than in cadavers. Our results should improve the awareness of anatomical variations in the first dorsal compartment, which in turn should have impact on treatment of de Quervain's disease in clinical practice.