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Journal of Bone and Joint Surgery, 1930;12:509-540.
© 1930 by The Journal of Bone and Joint Surgery, Inc

STENOSING TENDOVAGINITIS AT THE RADIAL STYLOID PROCESS

HARRY FINKELSTEIN M.D., F.A.C.S.1

1 Hospital for Joint Diseases, New York City

Stenosing tendovaginitis is a disease frequently encountered. Twenty-four cases were operated upon in a single institution within a period of two years. The laboring classes are most frequently affected. Chronic trauma and overexertion are the most common causes. The disease can be produced experimentally. The common tendon sheath of the abductor longus and extensor brevis pollicis muscles, occupying the first compartment on the dorsum of the radius, is most frequently involved, but any of the tendon sheaths on the flexor or extensor surfaces of the wrist may be affected. Only one bilateral case was encountered, but because the patient refused to submit to operation, the diagnosis could not be definitely confirmed. The pathologic changes are usually limited to a fibrous thickening of the tendon sheath, without evidences of acute inflammatory reaction. There may finally occur calcareous deposits in the sheath. In rare instances, however, the lesion may occur in the tendon itself, and often there are distinct evidences of inflammatory reactions in the peritendinous structures. The pain over the styloid process of the radius may be excruciating, causing disability and interfering with the pursuit of a livelihood. The disease is progressive; not amenable, except in rare instances, to conservative treatment after four weeks' duration; but responds readily to operative intervention, which consists of splitting the stenosed tendon sheath, or in severe cases, the entire removal of the tendon sheath.


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