Limited surgical treatment of de Quervain's disease: decompression of only the extensor pollicis brevis subcompartment.

A septum between the abductor pollicis longus tendon and the extensor pollicis brevis (EPB) tendon in the first extensor compartment is frequently encountered during surgical treatment of de Quervain's disease. It was hypothesized that de Quervain's disease was secondary to EPB entrapment and the decision was made to decompress only the EPB subcompartment. Twenty-two patients were treated with this method. Sixteen patients had a septum in the first extensor compartment and 6 patients had a single canal. After surgery, all patients had complete relief of pain and tenderness over the first extensor compartment. The results of Finkelstein's test were negative in all cases. We conclude that de Quervain's disease is secondary to EPB entrapment. In those cases with a septum, it is sufficient to decompress only the EPB subcompartment.