Release of the sixth dorsal compartment.

Twenty-two patients with normal x-ray films who required decompression of the sixth dorsal compartment for tenovaginitis were identified. Retrospective review of charts and operative reports were possible in 18, and 12 returned for reexamination at 43 months (average). All had preoperative tenderness along the extensor carpi ulnaris tendon increased by resisted ulnar deviation and forced radial deviation; all had had transient relief with injection of local anesthetic. Nonsurgical treatments were used for an average of 6 months prior to surgery. Thirteen patients related symptom onset to a single traumatic event, usually a forced twisting. Surgical release was achieved by simply incising the retinaculum with no attempt at repair. Postoperatively patients were followed for an average of 10 months to recovery; grip improved by 28%, to equal 79% of the unaffected side. Two patients required secondary Darrach resections for improvement. At late reexamination, grip strength averaged 94% of the unaffected side; there were no signs of distal ulna or extensor carpi ulnaris tendon instability. In our experience, surgical decompression for resistant sixth dorsal tenovaginitis does not destabilize the distal ulna or the extensor carpi ulnaris tendon.