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Tendon Subluxation After Surgical Release of the First Dorsal Compartment in De Quervain Disease

Kim, Ji-Hyo, PhD*; Yang, Seog-Won, MD; Ham, Hee-Jeong, MD; Kim, Jong-Pil, MD, PhD†‡

doi: 10.1097/SAP.0000000000001860
Hand Surgery
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We aimed to determine whether dorsoulnar incision elevating radial flap and immobilization for the treatment of de Quervain disease have an advantage over simple midline incision and early mobilization, respectively, in terms of tendon subluxation and clinical outcomes. Forty-six patients with de Quervain disease were randomly divided into 2 groups (midline incision vs dorsoulnar incision) and 2 subgroups (immobilization vs early mobilization). Subluxation of intracompartmental tendons was measured in dynamic wrist positions at 12 and 24 weeks using ultrasonography. The DASH (Disabilities of the Arm, Shoulder, and Hand) and visual analog scale scores and grip and pinch strengths were evaluated. At 24 weeks, the tendons were displaced voloradially in wrist volar flexion (1.25 mm in midline incision vs 0.36 mm in dorsoulnar incision, P = 0.001), whereas the tendons were displaced dorsoulnarly in wrist extension (0.95 mm in midline incision vs 1.78 mm in dorsoulnar incision, P = 0.041). There were no significant differences in tendon displacement between early mobilization and immobilization groups. Clinical outcome measures showed no variation between the groups, and no significant correlation occurred with tendon subluxation. Dorsoulnar incision and postoperative immobilization do not have advantage over midline incision and early mobilization, respectively. However, tendon subluxation after release of the first dorsal compartment for de Quervain disease does not affect clinical outcomes.

From the *Department of Career Education, College of General Education,

Department of Orthopedic Surgery, College of Medicine, and

Department of Kinesiology and Medical Science, Graduate School, Dankook University, Cheonan, Korea.

Received September 4, 2018, and accepted for publication, after revision December 30, 2018.

Conflicts of interest and sources of funding: none declared.

This work was supported by the Dankook University research fund.

This study was approved by the institutional review board of the authors' hospital, and all investigations were conducted in conformity with ethical principles of research. Informed consent was given by all patients for the surgical procedure.

Reprints: Jong-Pil Kim, MD, PhD, Department of Orthopedic Surgery, Dankook University College of Medicine, 119 Dandaero, Dongnam-gu, Cheonan 31116, Korea. E-mail: kimjp@dankook.ac.kr.

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