De Quervain’s tenosynovitis

What is it?

De Quervain’s tenosynovitis is a condition causing pain and swelling around the tendons that move the thumb. Patients often feel an ache or sharp pain near the base of the thumb or thumb side of the wrist when they are gripping or twisting. It can be caused by repetitive activities and commonly affects new mothers.

What are the treatment options?

  • Hand therapy and splinting of the thumb and wrist to help rest the tendons
  • Anti-inflammatory medicate such as ibuprofen
  • Corticosteroid injections into the tendon tunnel (1)
  • Surgery to release the tendon tunnel

What to expect with surgery?

De Quervain’s release involves a small oblique incision over the thumb side of the wrist usually performed under local or general anaesthetic as a day case procedure in hospital. The tunnel, in which the thumb tendons glide, is released to make more space for the tendons and remove any scarring which is causing the tendons to stick to the surrounding tissues.

What are the risks of surgery?

Risks of surgery include injury to the nerves that supply the skin over the back of the hand. This can lead to a sensitive scar or hypersensitivity or numbness on the back of the hand. After releasing the tendon tunnel, the tendons can slip out of position when moving the wrist, leading to pain and discomfort. Other general risks of surgery also include hypertrophic scarring or wound infection.

Severe De Quervain's with associated ganglion

Related Conditions

Hand Osteoarthritis

Ganglion cyst

References

  1. Peters-Veluthamaningal, Cyriac, Daniëlle A. W. M. van der Windt, Jan C. Winters, and Betty Meyboom-de Jong. “Corticosteroid Injection for de Quervain’s Tenosynovitis.” The Cochrane Database of Systematic Reviews, no. 3 (July 8, 2009): CD005616. https://doi.org/10.1002/14651858.CD005616.pub2.
  2. Goel, Ritu, and Joshua M. Abzug. “De Quervain’s Tenosynovitis: A Review of the Rehabilitative Options.” Hand (New York, N.Y.) 10, no. 1 (March 2015): 1–5. https://doi.org/10.1007/s11552-014-9649-3.
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Dr Avanthi Mandaleson

Specialist Hand & Upper Limb Surgeon​
(BMedSci, MBBS, FRACS, FAOrthA)

For all appointments please call (03) 9456 9077