Tenosynovitis of the hand and wrist is a group of entities with a common pathology affecting the extrinsic tendons of the hand and wrist and their corresponding retinacular sheaths. It usually begins as tendon irritation, manifesting as pain and swelling caused by increased production of synovial fluid (tendon sheath hygroma).
The treatment of choice is initially conservative with immobilization of the affected hand section. If the tenosynovitis occurs in the context of a specific underlying disease (PCP, psoriasis, LE etc.), medical treatment with the appropriate antirheumatic drugs should be carried out.
In case of failed conservative therapy, removal of the synovium is strongly recommended to stop the inflammatory process. Otherwise, tendon rupture is to be expected.
In the present case, it is a special form of tenosynovitis of the 4th SSF (EDC and EIP) after malunited radius fracture. The malposition of the bone had led to a hypomochlion with narrowing of the tendon canal. As a consequence, chronic irritation with synovitis and partial rupture of the tendons occurred. For recurrence prophylaxis, in addition to synovectomy, a retinaculum plasty was also performed (see procedure).
The retinaculum plasty has two goals: It protects the vulnerable tendons from direct contact with the bone and thus prevents renewed mechanical irritation. In addition, the tendons are recentered and regain their original straight course.