Die Erweiterungsplastik des ersten Strecksehnenfachs zur operativen Behandlung der Tendovaginitis de Quervain

Abstract

Reliable reduction of pain, observance of anatomical variations, avoidance of complications. Failure of conservative treatment, clinically obvious diagnosis, positive Finkelstein test (pathognomonic). Previous splitting of the retinaculum of the first dorsal compartment, uncertainty of diagnosis. Skin incision with protection of the branches of the superficial radial nerve, exposure of the first dorsal compartment, w-shaped incision and preparation of the retinaculum lobes, exposure of all tendons, inspection of the whole compartment and possible anatomic variations. Loose adaptation of the lobes, irrigation, hemostasis, skin closing. Consequent immobilization in a thumb cast for a total of 3weeks (+ 3weeks optional depending on load/profession). Sutures removed after 2weeks, then the patient can start mobilization exercises (without the splint) after 3 weeks. Between August 2005 and July 2007, 38patients (40wrists) were operated without complications. No tendon subluxation/dislocation, one wrist with persistent slightly positive Finkelstein test, in all other cases complete relief of the symptoms. All patients would elect to repeat the surgery.