Pulley Reconstruction Following Surgical Release of DC1 Pulley in De Quervain's Tenosynovitis: Surgical Technique and Case Series.

Abstract

De Quervain's disease (DQD) is tenosynovitis of the first dorsal compartment (DC1) of the wrist between the osteofibrous tunnel and the tendons involving the APL and EPB sheaths at the radial styloid. Surgical intervention is indicated when pain does not resolve despite 3 to 6 months of conservative management. Release of the first dorsal compartment is an effective treatment of DQD. In addition to surgical release, we performed pulley reconstruction using a new technique in the present series of 20 patients which has not been previously described with a followup of over 1 year. All patients showed a consistent improvement in VAS score at over one year followup with resolution of Finkelstein, Eichoff and WHAT test. Only one temporary neuropraxia was encountered due to stretching/scar entrapment of superficial branch of radial nerve. Our innovative technique of pulley reconstruction is not only easy to understand and perform but has shown consistent result in the 20 cases operated with this technique with a follow up of at least 1 year. The technique has the distinct advantage of having a quick learning curve and gives reliable, lasting results without complications or recurrence.