The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

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

Document Type : TECHNICAL NOTE

Authors
Ankit Khurana
Pratik Agarwal
Shailendra Chandra Gupta
Kuldeep Malik
Vishal Jain
Department of Orthopaedics, ESI Hospital Rohini, Delhi, India
10.22038/abjs.2021.58872.2913
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. 
Level of evidence: IV
Keywords
: De Quervain
Extensor tendon
First Extensor compartment
Pulley
Tendon subluxation
Tenosynovitis
Wide-awake hand surgery
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The Archives of Bone and Joint Surgery
Volume 10, Issue 5
May 2022
Pages 459-465

  • Receive Date 22 September 2021
  • Accept Date 25 October 2021