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Extensor Tendoscopy

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Arthroscopy and Endoscopy of the Hand, Wrist and Elbow

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Abstract

Extensor tenosynovitis of the wrist can be due to rheumatologic, metabolic, or traumatic causes. Extensor tendon rupture can occur in untreated cases especially in rheumatoid arthritis. Open synovectomy requires extensive soft tissue dissection and incision of the extensor retinaculum. Endoscopic synovectomy is a minimally invasive approach that can preserve the integrity of the extensor retinaculum of the wrist.

De Quervain’s tendonitis is a stenosing tenosynovitis of the first dorsal compartment involving the Extensor Pollicis Brevis (EPB) and Abductor Pollicis Longus (APL) tendons. Ultrasound has recently been found to provide an accurate method of diagnosis as well as identifying an accessory compartment which could influence treatment. When injections are given the results are typically improved with ultrasound guidance. The typical open treatment was first published by Fritz de Quervain in 1885. The endoscopic technique has recently been described using both a one-portal and a two-portal technique with excellent results.

Stenosing tenosynovitis of extensor carpi ulnaris tendon most often results from repetitive movements of the tendon along the narrow fibro-osseous canal of the sixth extensor compartment. When conservative treatment fails to relieve the symptoms, surgical release of the retinacular sheath of the sixth extensor compartment is the definitive treatment. Endoscopic release is a minimally invasive approach that provides an alternative to open release. Apart from much less soft tissue dissection, it preserves the extensor retinaculum.

The corresponding author of Sect. 9.1 is Tun Hing Lui, E-mail: luithderek@yahoo.co.uk

The corresponding author of Sect. 9.2 is Michael J. Fitzmaurice, E-mail: DrFitz@Fitzhand.com

The corresponding author of Sect. 9.3 is Tun Hing Lui, E-mail: luithderek@yahoo.co.uk

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References

  1. Ichihara S, Hidalgo-Diaz JJ, Prunières G, Facca S, Bodin F, Boucher S, et al. Hyperparathyroidism-related extensor tenosynovitis at the Wrist: a general review of the literature. Eur J Orthop Surg Traumatol. 2015;25(5):793–7.

    Article  Google Scholar 

  2. VanHeest AE, Luger NM, House JH, Vener M. Extensor retinaculum impingement in the athlete: a new diagnosis. Am J Sports Med. 2007;35(12):2126–30.

    Article  Google Scholar 

  3. Weinzweig J, Fletcher JW, Linburg RM. Flexor tendinitis and median nerve compression caused by gout in a patient with rheumatoid arthritis. Plast Reconstr Surg. 2000;106(7):1570–2.

    Article  CAS  Google Scholar 

  4. Cooper HJ, Shevchuk MM, Li X, Yang SS. Proliferative extensor tenosynovitis of the wrist in the absence of rheumatoid arthritis. J Hand Surg Am. 2009;34(10):1827–31.

    Article  Google Scholar 

  5. Brumfield R Jr, Kuschner SH, Gellman H, Liles DN, Van Winckle G. Results of dorsal wrist synovectomies in the rheumatoid hand. J Hand Surg. 1990;15(5):733–5.

    Article  Google Scholar 

  6. Khan KM, Cook JL, Bonar F, Harcourt P, Astrom M. Histopathology of common tendinopathies: update and implications for clinical management. Sports Med. 1999;27(6):393–408.

    Article  CAS  Google Scholar 

  7. Finkelstein H. Stenosan tenosing tendovagintis at the radial styloid process. J Bone Joint Surg. 1930;12(3):509–40.

    Google Scholar 

  8. Lui TH. Extensor tendoscopy of the wrist. Arthrosc Tech. 2016;5(4):e751–6.

    Article  Google Scholar 

  9. Lee K-H, Kang C-N, Lee BG, Jung W-S, Kim DY, Lee C-H. Ultrasonographic evaluation of the first extensor compartment of the wrist in de Quervain’s disease. J Orthop Sci. 2013;19(1):49–54.

    Article  Google Scholar 

  10. Keating-Hart ED, Touchais S, Kerjean Y, Ardouin L, Goff BL. Presence of an intracompartmental septum detected by ultrasound is associated with the failure of ultrasound-guided steroid injection in De Quervain’s syndrome. J Hand Surg (Eur Vol). 2016;41(2):212–9.

    Article  Google Scholar 

  11. McDermott JD, Ilyas AM, Nazarian LN, Leinberry CF. Ultrasound-guided injections for de Quervain’s tenosynovitis. Clin Orthop Relat Res. 2012;470(7):1925–31.

    Article  Google Scholar 

  12. Cor-Bl.f.schweiz. Aerzrte. On a form of chronic tendovaginitis. J Hand Surg (Eur Vol). 2005;30(4):388–91.

    Article  Google Scholar 

  13. Gu X, Hong Z, Chen X, et al. Tendoscopic versus open release for de Quervain’s disease: earlier recovery with 7.21 year follow-up. J Orthop Surg Res. 2019;14(1):357.

    Article  Google Scholar 

  14. Kang HJ, Koh IH, Jang JW, Choi YR. Endoscopic versus open release in patients with de Quervain’s tenosynovitis: a randomised trial. Bone Joint J. 2013;95-B(7):947–51.

    Article  CAS  Google Scholar 

  15. Slade JF III, Merrell G. Endoscopic DeQuervain’s release. In: Atlas of minimally invasive hand and wrist surgery. 2007.

    Google Scholar 

  16. Kang HJ, Hahn SB, Kim SH, Choi YR. Does endoscopic release of the first extensor compartment have benefits over open release in de Quervain’s disease? J Plast Reconstr Aesthet Surg. 2011;64(10):1306–11.

    Article  CAS  Google Scholar 

  17. Spinner M, Kaplan EB. Extensor carpi ulnaris: its relationship to the stability of the distal radio-ulnar joint. Clin Orthop Relat Res. 1973;68:124–9.

    Google Scholar 

  18. Crimmins CA, Jones NF. Stenosing tenosynovitis of the extensor carpi ulnaris. Ann Plast Surg. 1995;35:105–7.

    Article  CAS  Google Scholar 

  19. Wolfe SW, Hotchkiss RN, Pederson WC, Kozin SH, Cohen MS. Green’s operative hand surgery. 7th ed. Elsevier; 2017.

    Google Scholar 

  20. Sanmartin-Fernandez M, Couceiro-Otero J, Costas-Alvarez M, Sotelo-Garcia A. Extensor carpi ulnaris tenosynovitis caused by the tip of an oversized ulnar styloid: a case report. J Wrist Surg. 2015;4:65–7.

    Article  Google Scholar 

  21. Trumble T, Rayan GM, Budoff JE, Baratz M, Slutsky DJ. Principles of hand surgery and therapy. 3rd ed. Elsevier; 2017.

    Google Scholar 

  22. Kip PC, Peimer CA. Release of the sixth dorsal compartment. J Hand Surg Am. 1994;19:599–601.

    Article  CAS  Google Scholar 

  23. Hajj AA, Wood MB. Stenosing tenosynovitis of the extensor carpi ulnaris. J Hand Surg Am. 1986;11:519–20.

    Article  CAS  Google Scholar 

  24. Steffens K, Koob E. Diagnosis and therapy of tendovaginitis of the extensor carpi ulnaris. Z Orthop Ihre Grenzgeb. 1994;132:437–40.

    Article  CAS  Google Scholar 

  25. Lui TH, Lau AYC. Endoscopic ganglionectomy and release of the sixth extensor compartment. Arthrosc Tech. 2019;8:e111–5.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, Hong Kong

    Churk Hang Li, Shek Ng & Tun Hing Lui

  2. Fitzmaurice Hand Institute, Scottsdale, AZ, USA

    Michael J. Fitzmaurice

  3. The Second Affiliated Hospital, Shenzhen University, Shenzhen, China

    Tun Hing Lui

Authors
  1. Churk Hang Li
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  2. Michael J. Fitzmaurice
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  3. Shek Ng
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  4. Tun Hing Lui
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Corresponding author

Correspondence to Tun Hing Lui .

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Editors and Affiliations

  1. Department of Orthopaedics and Traumatology, North District Hospital, Hong Kong, China

    Tun Hing Lui

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Li, C.H., Fitzmaurice, M.J., Ng, S., Lui, T.H. (2021). Extensor Tendoscopy. In: Lui, T.H. (eds) Arthroscopy and Endoscopy of the Hand, Wrist and Elbow. Springer, Singapore. https://doi.org/10.1007/978-981-16-4142-8_9

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  • DOI: https://doi.org/10.1007/978-981-16-4142-8_9

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-16-4141-1

  • Online ISBN: 978-981-16-4142-8

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