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De Quervain's Tenosynovitis

De Quervain's Tenosynovitis

De Quervain's Tenosynovitis is a condition that results from inflammation of the tendons at the base of the thumb. These tendons run through a relatively rigid tunnel in the distal part of the forearm. Inflammation of the tissues surrounding the tendons in the tunnel results in De Quervain's Tenosynovitis.

 Signs and symptoms of De Quervain's Tenosynovitis

  • Pain and tenderness at the base of the thumb and/or on the side of the wrist closest to the thumb
  • Swelling on the thumb-side of the wrist
  • Difficulty moving your thumb and wrist when you're doing something that involves grasping or pinching
  • A "catching" or "snapping" feeling when you move your thumb.

If the condition goes too long without treatment, the pain may spread further into your thumb, back into your forearm or both. Pinching, grasping and other movements of your thumb and wrist aggravate the pain.

Preparing For Your De Quervain's Tenosynovitis Surgery

Before you have your surgery, there are a few preparation tips that we recommend. These will help you through your recovery. So, you understand exactly what surgery is planned, along with the risks, benefits, and other options. It is important to follow your surgeon's pre and post-op advice as this is specific to you. Make sure your doctor and the hospital have a copy of your advance directive. If you don't have one, you may want to prepare one. It lets others know your health care wishes. It's a good thing to have before any type of surgery or procedure.

Post Operative Activities

  • Patients will need to keep the incision site clean and dry until the physician removes the stitches 1 to 2 weeks after the procedure.
  • Using ice therapy every 1 to 2 hours during daytime for the first 3 days. Sessions should last no more than 10 to 15 minutes.
  • Avoiding use of the hand or wrist for activities that could strain the surgical site for 1 to 2 weeks, including lifting anything heavier than 1 kilogram, typing, doing household chores, or cooking.

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Frequently Asked questions

Due to inflammation, movements of the thumb and the wrist become painful. The ability to grip strongly, to open bottles or jars and to use tools such as a hammer are significantly affected. There can be a visible swelling in the lower part of the forearm and sometimes a crackling sensation can be felt underneath the skin when the thumb is moved.
Early symptoms may respond to rest, splintage, activity modification, anti inflammatory medication or an injection of steroid into the tunnel through which the tendons pass to reduce the inflammation. If the symptoms persist after two steroid injections four weeks apart and if other conservative measures have not been affective then surgery has to be considered for relief of pain and return of function.
Surgery for De Quervain's Tenosynovitis can be carried out under local anaesthetic or occasionally under brachial block anaesthesia (the arm is numbed with an injection) or general anaesthetic. It involves a small incision over the painful area after it has been numbed and the tight tunnel around the affected tendons is released.
Just like any other operation release of De Quervain's Tenosynovitis can result in problems such as bleeding, infection or delayed healing of the wound although these are very uncommon.
Most patients regain reasonable mobility between two and four weeks after the surgery but it takes longer to regain grip strength and power in the hand.

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