ਡੀ ਕੁਵਰਨ ਦਾ ਟੈਨੋਸਾਈਨੋਵਾਈਟਿਸ ਜਾਣਕਾਰੀ

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

Epidemiology and Patient Perspective

• Patients presenting with de Quervain's tenosynovitis may favor initial nonsurgical management [6].
• Patients who scored lower than 40 for physical function or higher than 60 for pain interference had significantly increased odds of eventually undergoing surgical release for de Quervain tenosynovitis [19].

Non-Operative Management

• Corticosteroid injection is the only available nonsurgical treatment that can potentially modify the course of de Quervain's tenosynovitis and is therefore the preferred initial treatment [2].
• Corticosteroid injection with a short duration of immobilization remains the primary and effective treatment for de Quervain tenosynovitis [14].
• Although the success rate for the treatment of De Quervain's tenosynovitis decreases with multiple injections, repeat injections have a high rate of success and are a viable clinical option [20].
• Addressing misconceptions about de Quervain's tenosynovitis in terms of the consequences for patients and how long their symptoms will last should allow patients to make informed decisions about the treatment that best matches their values [3].

Surgical Anatomy

• Variations in the surgical anatomy of the first extensor compartment are clinically relevant in the pathophysiology and treatment of De Quervain's tenosynovitis [1].

Operative Management

• Surgical release of De Quervain's tenosynovitis remains the gold standard treatment [4].
• Longitudinal incision offers the advantage of easy identification of compartment, more complete releases of tendon sheath and peritendinous adhesions, and less risk of palmar subluxation of tendons [4].
• The release of the first extensor compartment for refractory de Quervain's disease resulted in good clinical outcomes with minimal morbidity [12].
• Endoscopic release of the extensor compartment seems to be an effective and safe procedure in patients with de Quervain's disease who are unresponsive to nonoperative treatments, despite a little increase in operation time [23].
• Endoscopic release for de Quervain's tenosynovitis seems to provide earlier improvement after surgery, with fewer superficial radial nerve complications and greater scar satisfaction, when compared with open release [25].
• Pulley reconstruction gives satisfactory medium-term results and should be considered part of the surgical treatment for de Quervain tenosynovitis [7].

Anatomy & Pathophysiology

• Variations in the surgical anatomy of the first extensor compartment are clinically relevant to the pathophysiology and treatment of De Quervain's tenosynovitis [1].
• The superficial branch of the radial nerve is encountered in more than 50% of patients requiring surgery for De Quervain's tenosynovitis [45].
• Diagnostic maneuvers for De Quervain tenosynovitis that produce pain in a location other than the radial styloid may indicate other anatomic causes for the pain, such as a longitudinal split tear of the extensor pollicis brevis tendon [8].
• Wrist position influences in vivo extensor pollicis brevis tendon excursion [33].
• De Quervain tenosynovitis is associated with a significant decrease in maximum velocity during slow fist tasks [38].

Classification

• The prevalence of a septated first dorsal compartment is considerably higher than previously reported, most notably in patients with De Quervain tenosynovitis [31].
• In cases where constriction involves only the extensor pollicis brevis in a separate compartment, exploration of both compartments is advised [15].
• De Quervain's syndrome may not be an isolated pathology and could be secondary to underlying wrist pathology due to previous trauma [9].
• Post-traumatic de Quervain's syndrome is a rare condition that is often overlooked initially due to its rarity [10].
• Styloid abnormalities, though considered a manifestation of de Quervain's disease by some authors, do not affect the outcome of management [11].
• If diagnostic maneuvers for de Quervain tenosynovitis produce pain in a location other than the radial styloid, advanced imaging should be considered to identify other anatomic causes for the pain [8].
• Routine wrist radiography prior to surgeon evaluation is wasteful as patients do not benefit from the resulting radiologic data [5].
• Addressing misconceptions about de Quervain's tenosynovitis regarding consequences and symptom duration allows patients to make informed decisions about treatment [3].
• Longitudinal incision offers advantages including easy identification of the compartment, more complete release of the tendon sheath and peritendinous adhesions, and less risk of palmar subluxation of tendons [4].

Clinical Presentation

• Anatomical variations in the first extensor compartment are clinically relevant to the pathophysiology of De Quervain's tenosynovitis [1].
• De Quervain's syndrome may not be an isolated pathology and can be secondary to underlying wrist pathology due to previous trauma [9].
• Diagnostic maneuvers for De Quervain tenosynovitis that produce pain in a location other than the radial styloid should prompt consideration of advanced imaging to identify other anatomic causes for the pain [8].
• In cases with symptoms of De Quervain's syndrome where constriction involves only the extensor pollicis brevis in a separate compartment, exploration of both compartments is advised [15].
• The presence of an intracompartmental septum does not significantly affect clinical outcomes or complications following endoscopic release for De Quervain's syndrome [17].
• More negative perceptions of the consequences of De Quervain's tenosynovitis are associated with worse pain and reduced function at baseline in patients awaiting surgical decompression [18].
• Worse pain catastrophizing is associated with worse pain and reduced function at baseline in patients awaiting surgical decompression of De Quervain's tenosynovitis [18].
• Addressing misconceptions about the consequences for patients and the duration of symptoms allows patients to make informed decisions about treatment [3].
• Using the asymptomatic thumb as a standard measure to identify the symptomatic thumb's impairments associated with De Quervain's disease may lack validity [28].

Investigations

• Anatomical variations in the first extensor compartment are clinically relevant to the pathophysiology and treatment of De Quervain's tenosynovitis [1].
• Corticosteroid injection is the only nonsurgical treatment with evidence suggesting it can potentially modify the course of De Quervain's tenosynovitis [2].
• Addressing patient misconceptions regarding symptom duration and consequences facilitates informed decision-making regarding treatment [3].
• Surgical release of the first extensor compartment remains the gold standard treatment for De Quervain's tenosynovitis [4].
• Longitudinal incision for surgical release allows for easy identification of the compartment, more complete release of the tendon sheath and peritendinous adhesions, and less risk of palmar subluxation of tendons [4].
• Surgical release for refractory De Quervain's disease results in good clinical outcomes with minimal morbidity [12].
• Diagnostic maneuvers for De Quervain's tenosynovitis producing pain in a location other than the radial styloid should prompt consideration of advanced imaging to identify other anatomic causes [8].
• De Quervain's syndrome in some patients may be secondary to underlying wrist pathology due to previous trauma [9].
• Post-traumatic De Quervain's syndrome is uncommon, often overlooked initially, but typically successfully treated non-operatively once diagnosed [10].
• Styloid abnormalities, considered by some as a manifestation of De Quervain's disease, do not affect the outcome of management [11].
• Ultrasound is a useful imaging technique for diagnosing De Quervain's disease and provides information about anatomic variations within the first extensor compartment [29].
• Preoperative ultrasound is a worthwhile investigation in cases of De Quervain's disease [30].
• Ultrasound-guided percutaneous release in De Quervain's disease is a safe and reliable procedure without specific morbidity [34].
• Extensor pollicis brevis extension of the thumb interphalangeal joint is associated with a subcompartment of the first dorsal compartment, particularly in patients with De Quervain's disease [35].

Treatment

Non-Operative Management

• Corticosteroid injection is the preferred initial nonsurgical treatment for de Quervain's tenosynovitis as it is the only available nonsurgical treatment that can potentially modify the course of the disease [2].
• One or two local injections of 1 ml triamcinolone acetonide 10 mg/ml provided by general practitioners leads to short-term improvement in de Quervain's tenosynovitis when compared to placebo [22].
• Corticosteroid injections are a useful treatment for de Quervain's tenosynovitis, leading to treatment success 73.4% of the time within 2 injections [13].
• The efficacy of corticosteroid injections for de Quervain's tenosynovitis has been studied in only one small controlled clinical trial, which found steroid injections to be superior to thumb spica splinting [27].
• Pain and clinical outcomes significantly improved after corticosteroid injection in de Quervain's disease [24].
• Patients with diabetes mellitus have a decreased probability of success following a single corticosteroid injection for de Quervain tenosynovitis in comparison to nondiabetic patients, but the effectiveness of each additional injection does not appear to diminish [21].
• Post-traumatic de Quervain's syndrome is typically successfully treated non-operatively once diagnosed [10].
• Providers should remain cognizant that patients presenting with de Quervain's tenosynovitis may favor initial nonsurgical management [6].

Operative Management

• Surgical release of the first extensor compartment for refractory de Quervain's disease resulted in good clinical outcomes with minimal morbidity [12].
• Endoscopic release of the extensor compartment is an effective and safe procedure in patients with de Quervain's disease who are unresponsive to nonoperative treatments, despite a slight increase in operation time [23].
• One portal endoscopic assisted release of the extensor compartment is an effective and safe minimal invasive procedure with similar complication rates reported previously in open and endoscopic procedures in patients with de Quervain's disease who are unresponsive to non-operative treatments [32].
• Pulley reconstruction should be considered part of the surgical treatment for de Quervain tenosynovitis, as the technique gives satisfactory medium-term results [7].

Preoperative Evaluation and Patient Factors

• Styloid abnormalities do not affect the outcome of management of de Quervain's disease [11].
• Deferring routine wrist radiography prior to surgeon evaluation does not affect management, as the practice is wasteful and patients do not benefit from the resulting radiologic data [5].
• Addressing misconceptions about de Quervain's tenosynovitis regarding consequences and symptom duration allows patients to make informed decisions about treatment that matches their values [3].

Complications

• Diagnostic maneuvers for De Quervain tenosynovitis producing pain in a location other than the radial styloid may indicate other anatomic causes for the pain, such as a longitudinal split tear of the extensor pollicis brevis tendon [8].
• Patients with diabetes mellitus have a decreased probability of success following a single corticosteroid injection for De Quervain tenosynovitis compared to nondiabetic patients [21].
• Neither heavy manual labor nor trauma could be shown to be predisposing risk factors for De Quervain's tenosynovitis [36].
• Risk factors for De Quervain's in a young, active population include female gender, age greater than 40, and black race [37].

Recovery

• Corticosteroid injection with a short duration of immobilization is the primary and effective treatment for de Quervain tenosynovitis [14].
• Most informed patients initially elect symptomatic treatment for de Quervain's disease, and most experience symptom resolution within one year [26].
• Endoscopic release for de Quervain's tenosynovitis provides earlier improvement after surgery, with fewer superficial radial nerve complications and greater scar satisfaction, when compared with open release [25].
• More negative perceptions of the consequences of de Quervain's tenosynovitis and worse pain catastrophizing are associated with worse pain and reduced function at baseline in patients awaiting surgical decompression [18].

Key Evidence

• [L4] These variations are clinically relevant in the pathophysiology and treatment of De Quervain's tenosynovitis. [1] (10.1016/j.bjps.2016.08.020)
• [L4] According to the limited evidence available, injection of corticosteroids is the only available nonsurgical treatment that can potentially modify the course of de Quervain's tenosynovitis and is therefore the preferred initial treatment. [2] (10.1016/j.jhsa.2008.12.030)
• [L3] Addressing misconceptions about de Quervain's tenosynovitis in terms of the consequences for patients and how long their symptoms will last should allow patients to make informed decisions about the treatment that best matches their values. [3] (10.1097/corr.0000000000001577)
• [L4] Surgical release of De Quervain's tenosynovitis remains the gold standard treatment, and longitudinal incision offers advantage of easy identification of compartment, more complete releases of tendon sheath and peritendinous adhesions and less risk of palmar subluxation of tendons. [4] (10.1007/s12306-018-0585-1)
• [L3] The practice of obtaining routine wrist radiography prior to surgeon evaluation is wasteful as patients do not benefit from the resulting radiologic data. [5] (10.1055/s-0037-1606124)
• [L4] Providers should remain cognizant that patients presenting with de Quervain's tenosynovitis may favor initial nonsurgical management. [6] (10.1016/j.jhsg.2024.01.009)
• [L4] The authors believe the technique gives satisfactory medium-term results and should be considered part of the surgical treatment for de Quervain tenosynovitis. [7] (10.1055/s-0035-1556862)
• [L4] If diagnostic maneuvers for de Quervain tenosynovitis produce pain in a location other than the radial styloid, advanced imaging should be considered to identify other anatomic causes for the pain. [8] (10.1016/j.jhsa.2014.09.024)
• [L4] The results suggest that de Quervain's syndrome in a proportion of patients could be secondary to underlying wrist pathology due to previous trauma. [9] (10.1177/1758998315599796)
• [L4] Post-traumatic de Quervain's syndrome is very uncommon and often overlooked initially due to its rarity, but once diagnosed is typically successfully treated non-operatively. [10] (10.1177/1753193416646722)
• [L4] Though considered as a manifestation of de Quervain's disease by some authors, styloid abnormalities do not affect the outcome of management as proved in this study. [11] (10.1007/s11552-010-9258-8)
• [L4] The release of the first extensor compartment for refractory de Quervain's disease resulted in good clinical outcomes with minimal morbidity. [12] (10.4055/cios.2014.6.4.405)
• [L3] This study indicates that corticosteroid injections are a useful treatment for de Quervain's tenosynovitis, leading to treatment success 73.4% of the time within 2 injections. [13] (10.1177/1558944716681976)
• [L1] Corticosteroid injection with a short duration of immobilization remains the primary and effective treatment for de Quervain tenosynovitis. [14] (10.1016/j.jhsa.2024.03.003)
• [L4] In cases with symptoms of de Quervain's syndrome where the constriction involves only the extensor pollicis brevis in a separate compartment, exploration of both compartments is advised. [15] (10.2106/00004623-194931040-00019)
• [L4] The presence of a septum does not significantly affect clinical outcomes or complications following endoscopic release for de Quervain's syndrome. [17] (10.1177/17531934231214137)
• [L3] More negative perceptions of the consequences of de Quervain's tenosynovitis and worse pain catastrophizing are associated with worse pain and reduced function at baseline in patients awaiting surgical decompression of de Quervain's tenosynovitis. [18] (10.1097/corr.0000000000000992)
• [L4] Patients who scored lower than 40 for physical function or higher than 60 for pain interference had significantly increased odds of eventually undergoing surgical release for de Quervain tenosynovitis. [19] (10.1016/j.jhsa.2023.07.005)
• [L2] Although the success rate for the treatment of De Quervain's tenosynovitis decreases with multiple injections, repeat injections have a high rate of success and are a viable clinical option. [20] (10.1016/j.jhsa.2021.04.018)
• [L4] Patients with diabetes mellitus have a decreased probability of success following a single corticosteroid injection for de Quervain tenosynovitis in comparison to nondiabetic patients, but the effectiveness of each additional injection does not appear to diminish. [21] (10.1016/j.jhsa.2022.02.018)
• [L1] One or two local injections of 1 ml triamcinolonacetonide 10 mg/ml provided by general practitioners leads to improvement in the short term in participants with de Quervain's tenosynovitis when compared to placebo. [22] (10.1186/1471-2474-10-131)
• [L4] Endoscopic release of the extensor compartment seems to be an effective and safe procedure in patients with de Quervain's disease who are unresponsive to nonoperative treatments, despite a little increase in operation time. [23] (10.1016/j.bjps.2011.05.015)
• [L1] Pain and clinical outcomes significantly improved after corticosteroid injection in de Quervain's disease. [24] (10.1016/j.otsr.2019.11.015)
• [L1] Endoscopic release for de Quervain's tenosynovitis seems to provide earlier improvement after surgery, with fewer superficial radial nerve complications and greater scar satisfaction, when compared with open release. [25] (10.1302/0301-620x.95b7.31486)
• [L4] Most informed patients initially elect symptomatic treatment for de Quervain's disease, and most experience symptom resolution within one year. [26] (10.1007/s12593-009-0018-3)
• [L1] The efficacy of corticosteroid injections for de Quervain's tenosynovitis has been studied in only one small controlled clinical trial, which found steroid injections to be superior to thumb spica splinting. [27] (10.1002/14651858.cd005616.pub2)
• [L3] This finding may question the validity of using the asymptomatic thumb as a standard measure to identify the symptomatic thumb's impairments associated with de Quervain's disease. [28] (10.1197/j.jht.2008.03.004)
• [L5] Ultrasound is a useful imaging technique for diagnosing de Quervain's disease and provides important information about anatomic variations within the first extensor compartment. [29] (10.1136/bcr-2021-242173)
• [L4] Ultrasound is a worthwhile preoperative investigation in case of de Quervain's disease. [30] (10.1007/s12593-009-0001-z)
• [L3] The prevalence of a septated first dorsal compartment is considerably higher than previously reported, most notably in patients with De Quervain tenosynovitis. [31] (10.1177/1558944718810864)
• [L4] One portal endoscopic assisted release of the extensor compartment is an effective and safe minimal invasive procedure with similar complication rates reported previously in open and endoscopic procedures in patients with de Quervain's disease who are unresponsive to non-operative treatments. [32] (10.1016/j.aott.2018.10.004)
• [L4] In vivo EPB tendon excursion measures have been quantified, and wrist position has been found to have an influence on excursion. [33] (10.1016/j.jht.2017.12.004)
• [L4] Ultrasound-guided percutaneous release in de Quervain's disease is a safe and reliable procedure without specific morbidity. [34] (10.1055/s-0039-1678688)
• [L4] When it does, particularly in patients with de Quervain's disease, it is likely to reside in a subcompartment of the first dorsal compartment. [35] (10.1016/j.jhsa.2008.12.015)
• [L3] Neither heavy manual labor nor trauma could be shown to be predisposing risk factors for de Quervain's tenosynovitis. [36] (10.1186/s12891-015-0579-1)
• [L2] Risk factors for de Quervain's in our population include female gender, age greater than 40, and black race. [37] (10.1016/j.jhsa.2008.08.020)
• [L3] Those subjects demonstrate a significant decrease in maximum velocity in slow fist tasks, highlighting the need for comprehensive assessment to ascertain the full extent of functional limitations that can occur in the setting of hand pathology. [38] (10.1177/1558944717729218)
• [L2] The anatomical findings are consistent with previous studies, with an expectation to encounter the superficial branch of the radial nerve in more than 50% of patients. [45] (10.1055/s-0039-1688700)

References

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[2] Nonsurgical Treatment for de Quervain's Tenosynovitis. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2008.12.030

[3] Are Patient Expectations and Illness Perception Associated with Patient-reported Outcomes from Surgical Decompression in de Quervain’s Tenosynovitis?. Clinical Orthopaedics & Related Research. 2020. DOI: 10.1097/corr.0000000000001577

[4] Functional outcome of De Quervain’s tenosynovitis with longitudinal incision in surgically treated patients. MUSCULOSKELETAL SURGERY. 2019. DOI: 10.1007/s12306-018-0585-1

[5] Deferring Routine Wrist Radiography Does Not Affect Management of de Quervain Tendinopathy Patients. Journal of Wrist Surgery. 2017. DOI: 10.1055/s-0037-1606124

[6] De Quervain’s Tenosynovitis: As Seen from the Perspective of the Patient. Journal of Hand Surgery Global Online. 2024. DOI: 10.1016/j.jhsg.2024.01.009

[7] Pulley Reconstruction As Part of the Surgical Treatment for de Quervain Disease: Surgical Technique with Medium-Term Results. Journal of Wrist Surgery. 2015. DOI: 10.1055/s-0035-1556862

[8] Longitudinal Split Tear of the Extensor Pollicis Brevis Tendon: Report of 2 Cases. The Journal of Hand Surgery. 2015. DOI: 10.1016/j.jhsa.2014.09.024

[9] De Quervain’s syndrome: It may not be an isolated pathology. Hand Therapy. 2015. DOI: 10.1177/1758998315599796

[10] Post-traumatic de Quervain’s syndrome: a rare condition, often diagnosed late. Journal of Hand Surgery (European Volume). 2016. DOI: 10.1177/1753193416646722

[11] Does Radial Styloid Abnormality in de Quervain's Disease Affect the Outcome of Management?. HAND. 2010. DOI: 10.1007/s11552-010-9258-8

[12] Surgical Release of the First Extensor Compartment for Refractory de Quervain's Tenosynovitis: Surgical Findings and Functional Evaluation Using DASH Scores. Clinics in Orthopedic Surgery. 2014. DOI: 10.4055/cios.2014.6.4.405

[13] Effectiveness of Corticosteroid Injections for Treatment of de Quervain’s Tenosynovitis. HAND. 2016. DOI: 10.1177/1558944716681976

[14] Advancements in de Quervain Tenosynovitis Management: A Comprehensive Network Meta-Analysis. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2024.03.003

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[18] Which Psychological Variables Are Associated With Pain and Function Before Surgery for de Quervain’s Tenosynovitis? A Cross-sectional Study. Clinical Orthopaedics & Related Research. 2019. DOI: 10.1097/corr.0000000000000992

[19] Association of Patient-Reported Outcomes Measurement Information System Measures With Injection and Surgical Treatment Response in Patients With De Quervain Tenosynovitis. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2023.07.005

[20] De Quervain Tenosynovitis: An Evaluation of the Epidemiology and Utility of Multiple Injections Using a National Database. The Journal of Hand Surgery. 2022. DOI: 10.1016/j.jhsa.2021.04.018

[21] Effectiveness of Corticosteroid Injections in Diabetic Patients With De Quervain Tenosynovitis. The Journal of Hand Surgery. 2022. DOI: 10.1016/j.jhsa.2022.02.018

[22] Randomised controlled trial of local corticosteroid injections for de Quervain's tenosynovitis in general practice. BMC Musculoskeletal Disorders. 2009. DOI: 10.1186/1471-2474-10-131

[23] Does endoscopic release of the first extensor compartment have benefits over open release in de Quervain’s disease?. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2011. DOI: 10.1016/j.bjps.2011.05.015

[24] Prospective randomized comparison of ultrasonography-guided and blind corticosteroid injection for de Quervain's disease. Orthopaedics & Traumatology: Surgery & Research. 2020. DOI: 10.1016/j.otsr.2019.11.015

[25] Endoscopicversusopen release in patients with de Quervain’s tenosynovitis. The Bone & Joint Journal. 2013. DOI: 10.1302/0301-620x.95b7.31486

[26] Patient-centered care of de Quervain’s disease. Journal of Hand and Microsurgery. 2009. DOI: 10.1007/s12593-009-0018-3

[27] Corticosteroid injection for de Quervain's tenosynovitis. Cochrane Database of Systematic Reviews. 2009. DOI: 10.1002/14651858.cd005616.pub2

[28] Bilateral_Thu_mb's_Active_Range_of_Motion_and_Strength_in_de_Quervain's_Disease_S0894113008000483. Journal of Hand Therapy. 2008. DOI: 10.1197/j.jht.2008.03.004

[29] Type II de Quervain’s disease: depicting subcompartmentalisation with ultrasound. BMJ Case Reports. 2021. DOI: 10.1136/bcr-2021-242173

[30] Preoperative ultrasound in de Quervain’s disease: an investigation worth doing. Journal of Hand and Microsurgery. 2009. DOI: 10.1007/s12593-009-0001-z

[31] Prevalence of a Septated First Dorsal Compartment Among Patients With and Without De Quervain Tenosynovitis: An In Vivo Anatomical Study. HAND. 2018. DOI: 10.1177/1558944718810864

[32] One portal endoscopic release of the first extensor compartment in de Quervain's disease. Acta Orthopaedica et Traumatologica Turcica. 2020. DOI: 10.1016/j.aott.2018.10.004

[33] Ultrasound assessment of extensor pollicis brevis tendon excursion in different wrist positions in healthy people. Journal of Hand Therapy. 2019. DOI: 10.1016/j.jht.2017.12.004

[34] Ultrasound-Guided de Quervain's Tendon Release, Feasibility, and First Outcomes. Journal of Wrist Surgery. 2019. DOI: 10.1055/s-0039-1678688

[35] Thumb Interphalangeal Joint Extension By the Extensor Pollicis Brevis: Association With a Subcompartment and de Quervain's Disease. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2008.12.015

[36] Work related etiology of de Quervain’s tenosynovitis: a case-control study with prospectively collected data. BMC Musculoskeletal Disorders. 2015. DOI: 10.1186/s12891-015-0579-1

[37] Incidence of de Quervain's Tenosynovitis in a Young, Active Population. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2008.08.020

[38] Dynamic Functional Assessment of Hand Motion Using an Animation Glove: The Effect of Stenosing Tenosynovitis. HAND. 2017. DOI: 10.1177/1558944717729218

[45] A Prospective Evaluation of the Anatomy of the First Dorsal Compartment in Patients Requiring Surgery for De Quervain's Tenosynovitis. Journal of Wrist Surgery. 2019. DOI: 10.1055/s-0039-1688700