Title: Functional outcome of surgically treated De Quervain's tenosynovitis
Authors: Subodh Kumar Pathak, Pritam Maheshwari, Prahlad Ughareja, Sandeep Kumar Gour, Prashanth Raj M
DOI: http://dx.doi.org/10.18535/jmscr/v4i8.35
Patients with radial wrist pain secondary to de quervains tenosynovitis are commonly seen in any orthopaedic outpatient department. Initially the treatment is conservative, but surgical decompression of the first dorsal compartment is required if conservative treatment fails .We present the functional outcome of 28 patients treated surgically. From June 2014 to Jan 2016, 28 patients treated for DQ were included in the study. There were 28 patients with mean age of 41.2 years (range 31 to 66 years). Surgical decompression of the first dorsal compartment was done under local anaesthesia and the wrist was immobilised for 10 to 12 days post surgery. All the patients had negative finkelsteins test postoperatively and were able to carry out their day to day activities without any pain. There was a significant reduction in post operative DASH score compared to pre operative score. The mean VAS score was reduced from 6.18 preoperatively to 1.18 postoperatively 2 patients had hypaesthesia in the dermatome of sensory radial nerve. Adequate surgical decompression of both the tendons, APL and EPB leads to excellent functional outcome and minimum morbidity. Keywords: Stenosing tenosynovitis, Disability evaluation, De Quervain disease, DASH 1. Clarke MT, Lyall HA, Grant JW, Matthewson MH. The histopathology of de Quervain’s disease. J Hand Surg Br. 1998 Dec;23(6):732–4. 2. Read HS, Hooper G, Davie R. Histological appearances in post-partum de Quervain’s disease. J Hand Surg Br. 2000 Feb;25(1): 70–2 3. Knobloch K, Gohritz A, Spies M, Vogt PM. Neovascularisation in de Quervain’s disease of the wrist: novel combined therapy using sclerosing therapy with polidocanol and eccentric training of the forearms and wrists-a pilot report. Knee Surg Sports Traumatol Arthrosc. 2008 Aug;16(8):803–5 4. Lamphier TA, Crooker C, Crooker JL. De Quervain’s disease. IndMed Surg. 1965;34: 847–856.Bibliographic Links 5. Capasso G, Testa V, Maffulli N, Turco G, Piluso G. Surgical release of de Quervain’s stenosing tenosynovitis postpartum: can it wait? Int Orthop. 2002;26:23–25. doi: 10.1007/s00264-001-0302-8 6. Rassi G, Bleton R, Laporte D. Compartmental reconstruction for de Quervain stenosing tenosynovitis. Scand J Plast Reconstr Surg Hand Surg. 2006;40:46–48.doi: 10.1080/02844310500369987. 7. Elliott BG. Finkelstein’s test: a descriptive error that can produce a false positive. J Hand Surg (Br)1992;17:481–483. 8. Weiss AP, Akelman E, Tabatabai M. Treatment of de Quervain’s disease. J Hand Surg (Am) 1994;19:595–598. doi: 10.1016/0363-5023(94)90262-3 9. Walker MJ. Manual physical therapy examination and intervention of a patient with radial wrist pain: a case report. J Orthop Sports Phys Ther. 2004 Dec; 34(12):761–9. 10. Sawaizumi T, Nanno M, Ito H. De Quervain’s disease: efficacy of intra-sheath triamcinolone injection. Int Orthop. 2007;31:265–268. doi: 10.1007/s00264-006-0165-0. 11. Belsole RJ. De Quervain’s tenosynovitis: diagnostic and operative complications. Orthopedics. 1981;4:899–903 12. Yuasa K, Kiyoshige Y. Limited surgical treatment of de Quervain’s disease: decompression of only the extensor pollicis brevis subcompartment. J Hand Surg (Am) 1998;23:840–843. doi: 10.1016/S0363-5023(98)80160-3. Abstract
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