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A cadaveric study of the first dorsal compartment of the wrist and its content tendons: anatomical variations in the Indian population.

ABSTRACT: de Quervain's disease is a commonly encountered problem; its management is multimodal, and often, there is recurrence which is commonly associated with anatomical variation in the first dorsal compartment of the wrist. Our purpose was to find out the anatomical variation of the first dorsal compartment of the wrist in the general population to assess the anatomical basis of de Quervain's disease and its recurrence. In this cadaveric study, 86 wrists in 46 patients were dissected to search out the first dorsal compartment of the wrist and its content tendons, presence of septa in the compartment, and insertion of the tendons. Supernumerary tendons in the first dorsal compartment were seen in 74.41 % of cases. The most commonly found tendon arrangement was two abductor pollicis longus (APL) and one extensor pollicis brevis (EPB). In all cases, there was a fixed insertion of APL to the base of the first metacarpal. Among other sites, the most common site of insertion of APL is the trapezium, which was 56.14 %. Variations of EPB with respect to number, site of insertion, thickness, and bilaterality were also found. The presence of septations was found in 37.20 % of dissected cadaveric wrists. We had found supernumerary tendons or slips in the first dorsal compartment very commonly. The presence of a septum was less frequently found. So, it may be concluded that there is immense anatomical variation present in the first dorsal compartment of the wrist, supernumerary tendons/tendon slips are commonly found, there is a variation of insertions present in the population, septum/aberrant compartment are also present, and bilateral variations are present in the population. These variations may be responsible for recurrence and unilateral affection in de Quervain's disease.

SUBMITTER: Roy AJ

PROVIDER: S-EPMC3509286 | biostudies-literature | 2012 Dec

REPOSITORIES: biostudies-literature

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A cadaveric study of the first dorsal compartment of the wrist and its content tendons: anatomical variations in the Indian population.

Roy Amlan Jyoti AJ Roy Amarendra Nath AN De Chinmay C Banerji Debabrata D Das Suvam S Chatterjee Biplab B Halder Tarak Chandra TC

Journal of hand and microsurgery 20120726 2

de Quervain's disease is a commonly encountered problem; its management is multimodal, and often, there is recurrence which is commonly associated with anatomical variation in the first dorsal compartment of the wrist. Our purpose was to find out the anatomical variation of the first dorsal compartment of the wrist in the general population to assess the anatomical basis of de Quervain's disease and its recurrence. In this cadaveric study, 86 wrists in 46 patients were dissected to search out th ...[more]

PMID: 24293951

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Project description:To determine the entry for the dorsal pedicular screw in relation to the notch present at the junction of base of the lateral margin of superior articular process with superior border of transverse process in dorsal spine. The advantage of this technique is a constant and easily identifiable entry point which does not involve partial resection of the inferior facet, thus maintaining stability and maintaining the well defined transverse and sagittal screw angles and decreasing the incidence of medial and inferior pedicle violation.The study was carried out using ten cadavers (four male and six female). Spinal column was dissected completely from cadavers. Before the experiment, normal anatomy was confirmed on all cadavers excluding cases of spinal deformity. Dissection was done by the spine surgeons taking care to preserve all the bony landmarks near the entry point. This study was carried out bilaterally on pedicles between the first and twelfth thoracic (T) vertebrae.The relation of the superior articular notch and transverse process to the thoracic spine pedicles was studied. It was found that superior third of the pedicle was related to the superior articular notch and the transverse process in the first five thoracic vertebrae. The relation of these structures to the pedicle of the sixth thoracic vertebra was somewhat equally distributed between the superior and middle third of the pedicle. From the 7th to 12th thoracic vertebrae the superior articular process and transverse process were related to the middle third of the pedicle in almost all the cases. It is important to note that the inferior 1/3rd of the pedicle was not related to these landmarks at any of the levels.We conclude that the ideal pedicle entry point described here should be considered by surgeons during thoracic pedicle screw instrumentation. The notch at the base of the superior articular process will always remain constant and therefore an important anatomical landmark in guiding the screw toward the entry of the pedicle.

Dataset Information

A cadaveric study of the first dorsal compartment of the wrist and its content tendons: anatomical variations in the Indian population.

Publications

A cadaveric study of the first dorsal compartment of the wrist and its content tendons: anatomical variations in the Indian population.

Similar Datasets

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