Abstract
1. In patients who develop de Quervain's disease variations from the standard pattern of tendons at the wrist are the rule rather than the exception.
2. Conservative treatment is of no value.
3. Adequate exposure, allowing full recognition of all anatomical structures in the region, is advisable, but branches of the radial nerve must be treated with respect.
4. The extensor pollicis brevis tendon is normally small and may pass through a separate osteofibrous canal.
5. Though incision only of the stenosing tendon sheaths may be sufficient, thorough excision is more certain and does no harm.
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