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Release of the sixth dorsal compartment
1Department of Orthopaedic Surgery, School of Medicine and Biomedical Sciences, State University of New York, Buffalo.
The Journal of Hand Surgery
|July 1, 1994
Summary
Surgical decompression of the sixth dorsal compartment for tenovaginitis effectively treats wrist pain without causing instability. Patients experienced significant grip strength improvement and no long-term complications.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Musculoskeletal Disorders
Background:
- Tenovaginitis of the sixth dorsal compartment involves the extensor carpi ulnaris tendon.
- It often presents with pain exacerbated by specific wrist movements.
- Conservative treatments are frequently insufficient, necessitating surgical intervention.
Purpose of the Study:
- To evaluate the efficacy and safety of surgical decompression for sixth dorsal compartment tenovaginitis.
- To assess the impact of surgery on grip strength and wrist stability.
- To determine if surgical release leads to distal ulna or extensor carpi ulnaris tendon instability.
Main Methods:
- Retrospective review of 22 patients undergoing sixth dorsal compartment decompression.
- Analysis of preoperative symptoms, non-surgical treatment history, and surgical outcomes.
- Postoperative follow-up including clinical reexamination and grip strength measurement.
Main Results:
- Surgical release by retinacular incision improved grip strength by 28% postoperatively, reaching 79% of the unaffected side.
- Late reexamination showed grip strength at 94% of the unaffected side with no signs of instability.
- Two patients required secondary Darrach resections for further improvement.
Conclusions:
- Surgical decompression is a safe and effective treatment for resistant sixth dorsal compartment tenovaginitis.
- The procedure does not appear to destabilize the distal ulna or the extensor carpi ulnaris tendon.
- Significant functional recovery and grip strength restoration are expected outcomes.