Histological assessment of a septum in the first dorsal compartment: a fresh cadaver study.

Resistance of de Quervain's disease to conservative treatment has been associated with an intertendinous septum in the first compartment; little is known about the histological features of such a septum. This study aimed to examine the intertendinous septum histologically and note its variations. After dissecting the first extensor compartment of 24 hands from 12 fresh frozen cadavers, the presence of any intertendinous septa was determined. The length of the extensor retinaculum and intertendinous septum was measured; histological findings of the first compartment with or without septa were studied and compared with those of the third/fourth compartment. Intertendinous septa were observed in 12 of 24 wrists. Histological assessment of the intertendinous septum revealed tissue similar in composition to the retinaculum observed between the third and fourth compartments.

Anatomical variation of abductor pollicis longus in Indian population: A cadaveric study.

BACKGROUND: Many authors have reported the anatomical variation of abductor pollicis longus (APL) around the wrist and its association with de Quervain tenosynovitis (DQT), first carpo-metacarpal arthritis, and trapezio-metacarpal subluxation. From Indian subcontinent, there is only one original article and a few case reports on the variability of APL tendon insertion. MATERIALS AND METHODS: Fifty formaldehyde preserved cadaveric wrists were dissected to look for the anatomical variation of APL in the Indian population. RESULTS: The APL was found with single tendon in 2, double in 31, triple in 8, and quadruple in 8 extremities. A maximum of 6 tendon-slips were found in one cadaveric wrist. In all hands, the APL had at least one attachment to first metacarpal bone and in 46 hands (92%), there was second insertion to the trapezium bone. Of all tendon-slips of APL (n = 126), 44% of tendons (68 tendons) were inserted into the base of the first metacarpal bone. This was followed by the insertion into the trapezium in 42% tendons (52 tendons). CONCLUSION: Bi-tendinous APL is commonly observed on the dorsal compartment of the wrist in Indian population and these tendon-slips are commonly attached to the first metacarpal base and trapezium. This variation must be understood by the Indian Orthopedic surgeons as the response to treatment of DQT and reason for first carpo-metacarpal arthritis can be dependent on this anatomical variation.