WHAT YOU SHOULD KNOW
The most common version of this condition is referred to as DeQuervain’s tenosynovitis. All the tendons at the wrist pass under tight constricting bands. Normal daily use of the hand and wrist can cause swelling of the tendon liner tissue. Once swelling starts, there is not enough room to pass back and forth under the tight band. Friction develops which leads to more swelling and a vicious cycle sets in unless something is done.
MEDICAL HISTORY
Patients usually notice pain at the area of entrapment. The most common one is near the base of the thumb. Movement in certain directions, pinching or gripping makes the pain worse.
EXAMINATION
Pressure applied where the entrapment is located will be painful, and testing movement in certain directions will bring out the typical symptoms. Sometimes a localized swelling can be seen and felt.
ADDITIONAL TESTS
None are needed.
TREATMENT OPTIONS
| NON-OPERATIVE | SURGICAL RELEASE | |
| CONSISTS OF | Cortisone injection to shrink swelling around the tendons | Simple release of constricting band to make more space for tendons |
| FEATURES | Limit of 2 total injections | Outpatient, minimal incision |
| ADVANTAGES | Avoids surgery | Definitive solution to problem |
| DISADVANTAGES | Not effective for moderate to advanced conditions | Requires surgery, nerves irritated afterwards |
RECOVERY
Sutures are removed in the office 2 weeks after surgery. Until that time, the small wound must be kept clean and dry. Otherwise, there are no formal restrictions of any kind, and patients are encouraged to use the hand for all normal everyday activities. There will be some soreness because the body has had an intervention. Daily exercises to move the tendons that have now been freed must be done to prevent stiffness. Massage over the incision calms local nerve irritation and makes a softer scar when fully healed.
The information presented above is for general educational purposes only. Individual patient diagnoses, treatments, and results may vary substantially for a variety of reasons.
