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Functional outcome of De Quervain’s tenosynovitis with longitudinal incision in surgically treated patients

  • H. J. Mangukiya
  • A. KaleEmail author
  • N. P. Mahajan
  • U. Ramteke
  • J. Manna
Original Article
  • 18 Downloads

Abstract

Introduction

De Quervain described tenosynovitis of first dorsal compartment more than 120 years ago. Women, particularly of 4th–5th decades, are at more risk of developing disease. Steroid injection has been described as first line of management over many decades, but it is associated with some significant complications like depigmentation of skin, atrophy of subcutaneous tissue, suppurative tenosynovitis and even tendon rupture. Animal studies have also reported increased risk of peritendinous adhesions with steroid injection.

Materials and methods

We prospectively managed 46 cases of De Quervain’s tenosynovitis with longitudinal incision at tertiary care hospital from 2014 to 2016. There were totally 40 patients with 9 males and 31 females between age group of 28 and 62 years. All patients were evaluated using DASH and VAS scores preoperatively and post-operatively.

Results

The mean preoperative DASH score was 42.26 which reduced to 5.37 post-operatively. The mean preoperative VAS score was 7.30 which reduced to 2.33 post-operatively. Intraoperatively, we found peritendinous adhesions in 8 patients and ganglion arising from first dorsal compartment in one patient. Post-operatively, we found hypertrophic scar in 3 patients and persistent numbness to first dorsal web space due to injury to superficial radial nerve in 2 patients. Six patients had recurrent symptoms and required revision surgery.

Conclusion

Surgical release of De Quervain’s tenosynovitis remains the gold standard treatment, and longitudinal incision offers advantage of easy identification of compartment, more complete releases of tendon sheath and peritendinous adhesions and less risk of palmar subluxation of tendons.

Keywords

De Quervain Surgery Longitudinal incision Functional outcome 

Notes

Compliance with ethical standards

Conflict of interest

There is no conflict of interest.

Human and animal rights

This article does not contain any studies with animals performed by any of the authors.

Informed consent

A well informed consent was taken from all patients participating in the study.

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Copyright information

© Istituto Ortopedico Rizzoli 2019

Authors and Affiliations

  • H. J. Mangukiya
    • 1
  • A. Kale
    • 1
    Email author
  • N. P. Mahajan
    • 2
  • U. Ramteke
    • 2
  • J. Manna
    • 2
  1. 1.Department of OrthopaedicsB.J Medical College and Sassoon General HospitalPuneIndia
  2. 2.Grant Govt Medical College and Sir J.J Group of HospitalMumbaiIndia

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