Abstract
Background Simple decompression of the first extensor compartment is commonly used for treating
de Quervain disease, with the possible complication of subluxation of the tendons
of the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) over the
radial styloid. To prevent this painful subluxation of the tendons, several methods
of reconstructing the pulley have been proposed.
Questions/Purposes The purpose of our study was to evaluate a new technique for reconstructing the first
extensor compartment following a release for de Quervain disease.
Patients and Methods A retrospective study (mean length 40.4 months) was performed in 45 patients. The
outcome assessment involved two different questionnaires and ultrasound evaluation
of any tendon subluxation.
Results None of the patients required reoperation for tendon instability or incomplete decompression
of the first extensor compartment. Two patients experienced clicking around the radial
styloid after surgery. This was not related to the amount of volar migration of the
tendons.
Conclusions We believe the reconstruction proposed here is an effective method of preventing
painful subluxation of the APL and EPB following a release of the first extensor compartment.
Keywords
de Quervain disease - release tendons - pulley plasty
