gms | German Medical Science

Purpose: de Quervain's disease which is tenosynovitis of the 1st extensor compartment is very common. de Quervain's disease has several clinical tests. We conducted a clinical test at the actual surgery and measured the tendon gliding distance of EPB and APL and considered its clinical significance.

Methods: Eight cases of de Quervain's disease was examined. Both an EPB and an APL tendon sheath were opened by local anesthetic surgery and five clinical tests were performed to measure tendon gliding distance. The clinical test is Finkelstein test, Nozue - Iwahara test, Aso test, the EPB test, the APL test. In Nozue - Iwahara test, pain is occurred when the thumb is active palmar abduction while the patient's wrist joint is palmar flexion. In Aso test, pain is occurred when the thumb is active extension while the patient's wrist joint is dorsal flexion. In the EPB test, pain is occurred when the MPj strongly passive flexion at neutral position of wrist joint. In the APL test, pain is occurred when the CMj strongly adduction at slightly ulnar deviation of wrist joint. The EPB and the APL test is my originally.

Results: The gliding distance of EPB was 11.1 mm (range: 10-15) and APL was 9.3 mm (range: 5-15) on Finkelstein test. Nozue - Iwahara test was 9.1 mm (3-15) of EPB and 8.5 mm (3-15) of APL. Aso test was 10.9 mm (5-15) and 2.0 mm (0-5). The EPB test was 7.9 mm (5-10) and 1.1 mm (0-2). The ALP test was 1.8 mm (0 - 5) and 4.9 mm (4-6), respectively.

Conclusions: Finkelstein test and Nozue - Iwahara test seemed to cause large gliding distance of both tendons and clinically it was difficult to distinguish between tendon sheaths of either tendon. In the Aso test and the EPB test, the movement of EPB was larger than that of APL, and it was considered to be a "Selective EPB test". The only one, the APL test was bigger than APL compared to EPB. In terms of thinking this as a "Selective APL test", the gliding distance and its difference were small.