Anatomic Landmarks for the First Dorsal Compartment

Objective: Knowledge of anatomic landmarks for the first dorsal compartment can assist clinicians with management of de Quervain's disease. The radial styloid, the scaphoid tubercle, and Lister's tubercle can be used as superficial landmarks for the first dorsal compartment. Methods: Thirty-two cadaveric wrists were dissected, and measurements were taken from the predetermined landmarks to the extensor retinaculum. The compartments were also inspected for variability of the abductor pollicis longus tendon and intracompartmental septations. Results: The average length of the extensor retinaculum from its proximal to distal extent measured approximately 2.2 cm. The distal aspect of the radial styloid was 0.3 cm distal to the distal aspect of the extensor retinaculum, and the distance between the distal aspect of the extensor retinaculum and the APL-Lister's-Scaphoid juncture was approximately 0.5 cm. A separate compartment for the extensor pollicis brevis was noted in 35% of the specimens. The abductor pollicis longus tendon demonstrated great variability with 1, 2, 3, or 4 slips in 9%, 30%, 43%, or 26% of the specimens, respectively. Conclusion: The superficial bony prominences of the radial wrist can be used reliably as anatomic landmarks for the first dorsal compartment.