Scientific articleStenosing Synovitis of the Extensor Pollicis Longus Tendon
Section snippets
Case 1
A 26-year-old, right-handed banker and avid drummer presented with a 4-week history of left wrist pain in the area of Lister's tubercle, as well as a painful snapping of his thumb with extension. His medical history reflected no illness or injury to the left upper extremity. The patient had already tried immobilization. Radiographs showed no abnormalities. Magnetic resonance imaging (MRI) performed at an outside institution was of poor quality and failed to define the diagnosis. A targeted,
Case 2
A 44 year-old, right-handed man presented with a history of a fall onto his left hand 1 month earlier. He complained of painful snapping along the dorsal radial side of the wrist during thumb extension. The patient also reported a remote history of a wrist fracture that had healed uneventfully without surgical intervention. Medical history was otherwise noncontributory. The snapping of the thumb was visibly apparent and initially thought to be the result of subluxation of the EPL tendon over
Discussion
McMahon and Posner4 in 1994 reported a case of snapping thumb secondary to tenosynovitis in the third extensor compartment. They used the term triggering instead of snapping, and attributed it to a normal-sized tendon compressed by a small third compartment near the Lister's tubercle. In our cases, the snapping was caused by an enlarged tendon within a normal-sized third compartment. In 1995, Lanzetta et al described a case of posttraumatic snapping thumb, using the term triggering, at the
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2019, Clinics in Plastic SurgeryCitation Excerpt :It is their opinion that release of the second compartment provided ultimate relief for the patient. Extensor pollicis longus (EPL) tenosynovitis is a rare clinical entity outside of the rheumatoid hand.81,87,88 Described in the literature by mostly case reports, the etiology is vague but is most commonly associated after sustaining nondisplaced distal radius fractures.
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