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. 2022 Jan 29;4(2):118-121.
doi: 10.1016/j.jhsg.2022.01.001. eCollection 2022 Mar.

Surgical Management of the Trapezium Canal Syndrome: An Uncommon Presentation of Tenosynovitis of Flexor Carpi Radialis

Domenico Sergio Poggi  1 , Massimo Massarella  1 , Eleonora Piccirilli  2   3
Affiliations

Surgical Management of the Trapezium Canal Syndrome: An Uncommon Presentation of Tenosynovitis of Flexor Carpi Radialis

Domenico Sergio Poggi et al. J Hand Surg Glob Online. .

Abstract

Flexor carpi radialis (FCR) tenosynovitis is a condition characterized by pain over the volar radial wrist caused by inflammation of the FCR tendon sheath. It is an uncommon and often unrecognized pathology that could be misleading from a diagnostic and therapeutic point of view. Treatment usually involves immobilization, nonsteroidal anti-inflammatory drugs, and injections. In refractory cases, operative release of the FCR tendon sheath may be indicated. In this article, we report our experience in treating FCR tenosynovitis by surgically decompressing the trapezium canal, through which the tendon runs, at the wrist. In our experience, this surgical technique allows a good functional recovery with the resolution of painful symptoms without notable complications.

Keywords: Flexor carpi radialis; Tenosynovitis; Trapezium canal.

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Figures

Figure 1
Figure 1
Anatomic landmarks for the FCR. A Scaphoid projection. B Trapezium osteofibrous canal. C Flexor carpi radialis enthesis.
Figure 2
Figure 2
Axial view of the trapezium canal.
Figure 3
Figure 3
Axial view of surgical decompression of the FCR at the trapezium canal.
Figure 4
Figure 4
Coronal view of surgical decompression of the FCR at the trapezium canal.
Figure 5
Figure 5
X-ray of the affected hand showing the trapezium and the surrounding joint relationships.
Figure 6
Figure 6
Surgical approach to the FCR at the trapezium canal.
Figure 7
Figure 7
Intraoperative finding of the prominent medial border of the trapezium compressing the FCR.
Figure 8
Figure 8
Partial trapezium osteotomy and FCR decompression.
Figure 9
Figure 9
Trapezium canal aspect at the end of the procedure.
Figure 10
Figure 10
Clinical examination after surgical repair showing complete range of motion with no pain.
See this image and copyright information in PMC

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