De Quervain's Tenosynovitis Info In-depth Evidence
Reviewed by Dr Kieran Hirpara, Specialist Orthopaedic Surgeon Last reviewed
Also on YouTube.
Video transcript
De Quervain's is felt on the thumb side of the wrist. Two tendons of the thumb run through a tight tunnel, and can become irritated. It hurts to grip, or to lift with the thumb. Gardening and weeding are classic triggers, and so is lifting a young child. Many people notice a catch, or some swelling, right at the base of the thumb. Most cases settle without surgery. The first step is to calm the irritated tendons. A thumb splint rests the wrist and thumb, and you should avoid the gripping and twisting that set it off. A cortisone injection into the tunnel can be very effective, and is often all that is needed. Simple changes to how you lift and garden help stop it returning. Given time, and a little patience, the wrist usually quietens down. If the pain keeps coming back despite splinting and an injection, a small release operation reliably settles it. It is done as day surgery, through a short incision over the thumb side of the wrist. The tight tunnel is opened, giving the two tendons room to glide freely again. The procedure is brief. You are awake, or asleep, and you go home the same day, with a light dressing over the wrist. Recovery is usually quick. The dressing stays on for a few days, and gentle thumb and wrist movement starts early, to keep everything gliding. Most people are back to light daily tasks within a week or two. The wrist feels steadily stronger over the following weeks. Heavier gripping and gardening come back a little later. Once it has healed, lasting relief is the usual result.
What you're feeling
You will likely feel pain on the thumb side of your wrist. This is where your wrist meets your hand, near the base of your thumb. The pain often starts gradually but can become sharp or burning. You might notice swelling in this area, which can make the skin feel tight or warm to the touch.
The pain tends to flare up when you move your thumb or wrist. Everyday tasks that involve gripping or pinching can become difficult. You may find it hard to lift a coffee mug, turn a key in a door, or open a jar. Twisting motions, such as wringing out a wet towel or turning a steering wheel, often trigger a sharp sting. Even simple actions like shaking hands or holding your phone can cause discomfort.
Symptoms often worsen after periods of activity. You might feel more pain at the end of the day or after doing repetitive hand work. Some people notice their wrist feels stiff and achy when they first wake up in the morning. This stiffness usually eases slightly as you start to move, but the pain returns with further use.
If the condition persists, the pain can interfere with sleep. You might find it hard to find a comfortable position for your hand, or the throbbing sensation can keep you awake. In some cases, you may feel a catching or snapping sensation when you move your thumb. This happens because the tendons that move your thumb are inflamed and swollen within their sheath.
It is important to recognise that pain in this specific area is a key sign. If your pain is located elsewhere on the wrist, or if you have a history of injury to that spot, your surgeon may look for other causes. Persistent pain on the radial side of the wrist following an injury could still be related to this condition, but it requires careful assessment. Understanding these patterns helps you and your surgeon decide on the best path forward.
What's actually happening
Your thumb moves because two small tendons slide smoothly through a tight tunnel on the outside of your wrist. Think of these tendons like ropes and the tunnel like a sleeve. In de Quervain’s tenosynovitis, the lining of that sleeve becomes swollen and inflamed. This swelling makes the space tighter, so the tendons rub against each other and the tunnel walls instead of gliding freely.
This friction causes the pain you feel on the side of your wrist near your thumb. The area is sensitive to touch, and simple movements like gripping or twisting can trigger sharp discomfort. Sometimes, the swelling is so significant that the tendons catch or lock, a condition known as triggering. This is rare, but when it happens, it often requires surgical release to restore smooth movement.
Your surgeon will check for this specific pattern of pain. If you have pain in a different location, they may look for other causes. The goal is to reduce the swelling in that sleeve so your tendons can move without irritation. Most people start with non-surgical treatments to calm this inflammation down.
What we can do about it
Dr Kieran Hirpara, an upper-limb surgeon at Mater Private Hospital Rockhampton, starts with the least invasive options that suit your condition. We begin with self-management and physiotherapy. You can rest your hand and avoid movements that trigger pain. A physiotherapist will guide you through gentle exercises to reduce stiffness and improve strength. We often use splinting to support your thumb and wrist. This helps the inflamed tendon sheath heal. Give these conservative measures a fair trial before considering stronger interventions.
If symptoms persist, we move to medical management. We may recommend pain relief or anti-inflammatory medication to help you manage discomfort. The preferred initial treatment is a corticosteroid injection into the affected tendon sheath. This is the only nonsurgical treatment that can potentially modify the course of your condition. Corticosteroid injections are effective, leading to treatment success 73.4% of the time within two injections. A single injection was effective in alleviating symptoms in 82% of patients, with over half remaining symptom-free for at least 12 months. We may combine the injection with a short period of immobilisation to optimise results. For diabetic patients, the probability of success following a single injection is lower, but additional injections remain effective.
Surgery is considered when non-operative care has not given enough improvement. We offer surgical release to open the tight sheath around the tendon. Endoscopic release seems to provide earlier improvement after surgery, with fewer nerve complications and greater scar satisfaction compared with open release. We discuss all options with you to ensure the treatment matches your values and lifestyle.
Patients are generally referred to our clinic by their GP; if a physiotherapist has suggested you see us, you will still need a referral from your GP in order to be eligible for the Medicare rebate. A clinic assessment establishes the diagnosis. For long-standing problems, we usually try non-operative care first. We consider surgery when that has not given enough improvement.
What to expect
De Quervain’s tenosynovitis is a condition where the tendons on the side of your wrist become inflamed. It often causes pain when you grip or twist your hand. The good news is that most people do not need surgery right away. Initial treatment usually involves non-surgical options, with corticosteroid injections being the preferred first step. This injection can help reduce inflammation and modify how the condition progresses.
If you have diabetes, you should know that a single injection may be less likely to succeed compared to someone without diabetes. However, additional injections remain effective for many patients with diabetes. Overall, corticosteroid injections lead to treatment success 73.4% of the time within two injections. If the first injection does not fully resolve your symptoms, repeat injections are a viable option with a high rate of success, even if the success rate decreases slightly with each additional treatment.
For those who do not receive injections or if they are not effective, the condition can persist. About 34.9% of patients with new stenosing tenosynovitis required surgery within a 2-year follow-up period. Most patients who eventually need surgery progress to that point within 1 year of presentation. If your pain interferes significantly with daily life or your physical function scores are low, you may be more likely to consider surgical release.
If surgery is needed, the outlook remains positive. Endoscopic release, a minimally invasive technique, often provides earlier improvement than traditional open surgery. It is also associated with fewer nerve complications and greater satisfaction with the resulting scar. While some patients worry about long-term stiffness or complications, these are rare. Stiffness in the finger joints is uncommon, and most patients find that their symptoms settle with appropriate management. Your surgeon will help you decide which path fits your values and lifestyle best.
When to see someone
See your GP if you have persistent pain on the thumb side of your wrist that does not improve with rest. Ask for a specialist review if you notice weakness, instability, or if your thumb locks or gives way. Seek help if symptoms interfere with sleep or work, or if you experience a sudden worsening of pain. If diagnostic tests cause pain in a location other than the radial styloid, advanced imaging may be needed to identify other causes. Persistent radial wrist pain following an injury could also be due to de Quervain’s syndrome. Early assessment helps ensure you receive the most appropriate treatment for your specific situation.
Advanced reading: the deeper science (optional)
This section goes further than you need for your own treatment decisions. De Quervain's tenosynovitis is worth the extra reading because of a small anatomical variant that accounts for much of the dissatisfaction after an operation that is otherwise reliable — and because the best non-operative result comes from combining two treatments rather than choosing between them.
The combination beats either part
The first dorsal compartment holds two tendons in a tunnel at the thumb side of the wrist. Treatment aims to settle inflammation in that tunnel and reduce the load passing through it.
A network meta-analysis of 823 patients concluded that corticosteroid injection with a short duration of immobilisation remains the primary and effective treatment, with extracorporeal shockwave therapy a secondary option [1]. Looking at the components directly, combined orthosis and corticosteroid injection approaches are more effective than either intervention alone [2].
That is a more specific instruction than "try a splint, then an injection if it fails". The evidence supports doing both together, with the splint worn for a defined short period after the injection.
A second injection is still worth having
Where symptoms return, the reflex is to conclude injections have failed and to move to surgery. The data across a large cohort say otherwise: although the success rate decreases with multiple injections, repeat injections have a high rate of success and are a viable clinical option [3].
Declining success with repetition is expected. But a lower success rate is not the same as futility, and a second injection remains a reasonable step rather than a delaying tactic.
The variant that explains most surgical disappointment
Release of the first dorsal compartment is effective, and where it disappoints there is usually a specific reason. Dissatisfaction can result from incomplete release, tendon subluxation, nerve injury, or simply the duration of recovery — and an unidentified and unreleased extensor pollicis brevis subsheath is a discrete source of dissatisfaction [4].
This deserves unpacking because it is the single most useful fact in this section. In a substantial proportion of people the compartment is not one tunnel but two, with the extensor pollicis brevis tendon running in its own separate sheath alongside the other. A release that opens the main compartment and stops leaves that second sheath intact — and the tendon inside it still compressed. The wrist is opened, the operation is completed as described, and the symptoms persist.
It is also why the two other listed causes matter: releasing too widely allows the tendons to subluxate out of the groove with wrist movement, producing a painful snap, and the superficial branch of the radial nerve crosses immediately over the operative field. The compartment must be opened completely but not excessively, with a nerve in the way — which is why an apparently minor operation warrants the same care as a larger one.
Not everything at the radial wrist is de Quervain's
Pain in this region has a differential worth knowing, because the treatments differ: arthritis at the base of the thumb, intersection syndrome a few centimetres further up the forearm, and radial nerve irritation can all produce pain in overlapping territory. A localised tenderness directly over the compartment, with pain reproduced by ulnar deviation of the wrist with the thumb tucked in the palm, is what points to the tendon sheath rather than to its neighbours.
References for the advanced reading
- Chong HH, Pradhan A, Dhingra M, Liong W, Hau MY, Shah R. Advancements in de Quervain tenosynovitis management: a comprehensive network meta-analysis of randomized controlled trials. J Hand Surg Am. 2024;49(6):557-69.
- Cavaleri R, Schabrun SM, Te M, Chipchase LS. Hand therapy versus corticosteroid injections in the treatment of de Quervain's disease: a systematic review and meta-analysis. J Hand Ther. 2016;29(1):3-11.
- Hassan K, Sohn A, Shi L, Lee M, Wolf JM. De Quervain tenosynovitis: an evaluation of the epidemiology and utility of multiple injections using a national database. J Hand Surg Am. 2022;47(3):284.e1-284.e6.
- Rogozinski B, Lourie GM. Dissatisfaction after first dorsal compartment release for de Quervain tendinopathy. J Hand Surg Am. 2016;41(1):117-9.
Evidence & references
This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.
Overview
Epidemiology and Patient Perspective
- Patients presenting with de Quervain's tenosynovitis may favor initial nonsurgical management [6].
- Patients who scored lower than 40 for physical function or higher than 60 for pain interference had significantly increased odds of eventually undergoing surgical release for de Quervain tenosynovitis [19].
Non-Operative Management
- Corticosteroid injection is the only available nonsurgical treatment that can potentially modify the course of de Quervain's tenosynovitis and is therefore the preferred initial treatment [2].
- Corticosteroid injection with a short duration of immobilization remains the primary and effective treatment for de Quervain tenosynovitis [14].
- Although the success rate for the treatment of De Quervain's tenosynovitis decreases with multiple injections, repeat injections have a high rate of success and are a viable clinical option [20].
- Addressing misconceptions about de Quervain's tenosynovitis in terms of the consequences for patients and how long their symptoms will last should allow patients to make informed decisions about the treatment that best matches their values [3].
Surgical Anatomy
- Variations in the surgical anatomy of the first extensor compartment are clinically relevant in the pathophysiology and treatment of De Quervain's tenosynovitis [1].
Operative Management
- Surgical release of De Quervain's tenosynovitis remains the gold standard treatment [4].
- Longitudinal incision offers the advantage of easy identification of compartment, more complete releases of tendon sheath and peritendinous adhesions, and less risk of palmar subluxation of tendons [4].
- The release of the first extensor compartment for refractory de Quervain's disease resulted in good clinical outcomes with minimal morbidity [12].
- Endoscopic release of the extensor compartment seems to be an effective and safe procedure in patients with de Quervain's disease who are unresponsive to nonoperative treatments, despite a little increase in operation time [23].
- Endoscopic release for de Quervain's tenosynovitis seems to provide earlier improvement after surgery, with fewer superficial radial nerve complications and greater scar satisfaction, when compared with open release [25].
- Pulley reconstruction gives satisfactory medium-term results and should be considered part of the surgical treatment for de Quervain tenosynovitis [7].
Anatomy & Pathophysiology
- Variations in the surgical anatomy of the first extensor compartment are clinically relevant to the pathophysiology and treatment of De Quervain's tenosynovitis [1].
- The superficial branch of the radial nerve is encountered in more than 50% of patients requiring surgery for De Quervain's tenosynovitis [45].
- Diagnostic maneuvers for De Quervain tenosynovitis that produce pain in a location other than the radial styloid may indicate other anatomic causes for the pain, such as a longitudinal split tear of the extensor pollicis brevis tendon [8].
- Wrist position influences in vivo extensor pollicis brevis tendon excursion [33].
- De Quervain tenosynovitis is associated with a significant decrease in maximum velocity during slow fist tasks [38].
Classification
- The prevalence of a septated first dorsal compartment is considerably higher than previously reported, most notably in patients with De Quervain tenosynovitis [31].
- In cases where constriction involves only the extensor pollicis brevis in a separate compartment, exploration of both compartments is advised [15].
- De Quervain's syndrome may not be an isolated pathology and could be secondary to underlying wrist pathology due to previous trauma [9].
- Post-traumatic de Quervain's syndrome is a rare condition that is often overlooked initially due to its rarity [10].
- Styloid abnormalities, though considered a manifestation of de Quervain's disease by some authors, do not affect the outcome of management [11].
- If diagnostic maneuvers for de Quervain tenosynovitis produce pain in a location other than the radial styloid, advanced imaging should be considered to identify other anatomic causes for the pain [8].
- Routine wrist radiography prior to surgeon evaluation is wasteful as patients do not benefit from the resulting radiologic data [5].
- Addressing misconceptions about de Quervain's tenosynovitis regarding consequences and symptom duration allows patients to make informed decisions about treatment [3].
- Longitudinal incision offers advantages including easy identification of the compartment, more complete release of the tendon sheath and peritendinous adhesions, and less risk of palmar subluxation of tendons [4].
Clinical Presentation
- Anatomical variations in the first extensor compartment are clinically relevant to the pathophysiology of De Quervain's tenosynovitis [1].
- De Quervain's syndrome may not be an isolated pathology and can be secondary to underlying wrist pathology due to previous trauma [9].
- Diagnostic maneuvers for De Quervain tenosynovitis that produce pain in a location other than the radial styloid should prompt consideration of advanced imaging to identify other anatomic causes for the pain [8].
- In cases with symptoms of De Quervain's syndrome where constriction involves only the extensor pollicis brevis in a separate compartment, exploration of both compartments is advised [15].
- The presence of an intracompartmental septum does not significantly affect clinical outcomes or complications following endoscopic release for De Quervain's syndrome [17].
- More negative perceptions of the consequences of De Quervain's tenosynovitis are associated with worse pain and reduced function at baseline in patients awaiting surgical decompression [18].
- Worse pain catastrophizing is associated with worse pain and reduced function at baseline in patients awaiting surgical decompression of De Quervain's tenosynovitis [18].
- Addressing misconceptions about the consequences for patients and the duration of symptoms allows patients to make informed decisions about treatment [3].
- Using the asymptomatic thumb as a standard measure to identify the symptomatic thumb's impairments associated with De Quervain's disease may lack validity [28].
Investigations
- Anatomical variations in the first extensor compartment are clinically relevant to the pathophysiology and treatment of De Quervain's tenosynovitis [1].
- Corticosteroid injection is the only nonsurgical treatment with evidence suggesting it can potentially modify the course of De Quervain's tenosynovitis [2].
- Addressing patient misconceptions regarding symptom duration and consequences facilitates informed decision-making regarding treatment [3].
- Surgical release of the first extensor compartment remains the gold standard treatment for De Quervain's tenosynovitis [4].
- Longitudinal incision for surgical release allows for easy identification of the compartment, more complete release of the tendon sheath and peritendinous adhesions, and less risk of palmar subluxation of tendons [4].
- Surgical release for refractory De Quervain's disease results in good clinical outcomes with minimal morbidity [12].
- Diagnostic maneuvers for De Quervain's tenosynovitis producing pain in a location other than the radial styloid should prompt consideration of advanced imaging to identify other anatomic causes [8].
- De Quervain's syndrome in some patients may be secondary to underlying wrist pathology due to previous trauma [9].
- Post-traumatic De Quervain's syndrome is uncommon, often overlooked initially, but typically successfully treated non-operatively once diagnosed [10].
- Styloid abnormalities, considered by some as a manifestation of De Quervain's disease, do not affect the outcome of management [11].
- Ultrasound is a useful imaging technique for diagnosing De Quervain's disease and provides information about anatomic variations within the first extensor compartment [29].
- Preoperative ultrasound is a worthwhile investigation in cases of De Quervain's disease [30].
- Ultrasound-guided percutaneous release in De Quervain's disease is a safe and reliable procedure without specific morbidity [34].
- Extensor pollicis brevis extension of the thumb interphalangeal joint is associated with a subcompartment of the first dorsal compartment, particularly in patients with De Quervain's disease [35].
Treatment
Non-Operative Management
- Corticosteroid injection is the preferred initial nonsurgical treatment for de Quervain's tenosynovitis as it is the only available nonsurgical treatment that can potentially modify the course of the disease [2].
- One or two local injections of 1 ml triamcinolone acetonide 10 mg/ml provided by general practitioners leads to short-term improvement in de Quervain's tenosynovitis when compared to placebo [22].
- Corticosteroid injections are a useful treatment for de Quervain's tenosynovitis, leading to treatment success 73.4% of the time within 2 injections [13].
- The efficacy of corticosteroid injections for de Quervain's tenosynovitis has been studied in only one small controlled clinical trial, which found steroid injections to be superior to thumb spica splinting [27].
- Pain and clinical outcomes significantly improved after corticosteroid injection in de Quervain's disease [24].
- Patients with diabetes mellitus have a decreased probability of success following a single corticosteroid injection for de Quervain tenosynovitis in comparison to nondiabetic patients, but the effectiveness of each additional injection does not appear to diminish [21].
- Post-traumatic de Quervain's syndrome is typically successfully treated non-operatively once diagnosed [10].
- Providers should remain cognizant that patients presenting with de Quervain's tenosynovitis may favor initial nonsurgical management [6].
Operative Management
- Surgical release of the first extensor compartment for refractory de Quervain's disease resulted in good clinical outcomes with minimal morbidity [12].
- Endoscopic release of the extensor compartment is an effective and safe procedure in patients with de Quervain's disease who are unresponsive to nonoperative treatments, despite a slight increase in operation time [23].
- One portal endoscopic assisted release of the extensor compartment is an effective and safe minimal invasive procedure with similar complication rates reported previously in open and endoscopic procedures in patients with de Quervain's disease who are unresponsive to non-operative treatments [32].
- Pulley reconstruction should be considered part of the surgical treatment for de Quervain tenosynovitis, as the technique gives satisfactory medium-term results [7].
Preoperative Evaluation and Patient Factors
- Styloid abnormalities do not affect the outcome of management of de Quervain's disease [11].
- Deferring routine wrist radiography prior to surgeon evaluation does not affect management, as the practice is wasteful and patients do not benefit from the resulting radiologic data [5].
- Addressing misconceptions about de Quervain's tenosynovitis regarding consequences and symptom duration allows patients to make informed decisions about treatment that matches their values [3].
Complications
- Diagnostic maneuvers for De Quervain tenosynovitis producing pain in a location other than the radial styloid may indicate other anatomic causes for the pain, such as a longitudinal split tear of the extensor pollicis brevis tendon [8].
- Patients with diabetes mellitus have a decreased probability of success following a single corticosteroid injection for De Quervain tenosynovitis compared to nondiabetic patients [21].
- Neither heavy manual labor nor trauma could be shown to be predisposing risk factors for De Quervain's tenosynovitis [36].
- Risk factors for De Quervain's in a young, active population include female gender, age greater than 40, and black race [37].
Recovery
- Corticosteroid injection with a short duration of immobilization is the primary and effective treatment for de Quervain tenosynovitis [14].
- Most informed patients initially elect symptomatic treatment for de Quervain's disease, and most experience symptom resolution within one year [26].
- Endoscopic release for de Quervain's tenosynovitis provides earlier improvement after surgery, with fewer superficial radial nerve complications and greater scar satisfaction, when compared with open release [25].
- More negative perceptions of the consequences of de Quervain's tenosynovitis and worse pain catastrophizing are associated with worse pain and reduced function at baseline in patients awaiting surgical decompression [18].
Key Evidence
- [L4] These variations are clinically relevant in the pathophysiology and treatment of De Quervain's tenosynovitis. [1] (10.1016/j.bjps.2016.08.020)
- [L4] According to the limited evidence available, injection of corticosteroids is the only available nonsurgical treatment that can potentially modify the course of de Quervain's tenosynovitis and is therefore the preferred initial treatment. [2] (10.1016/j.jhsa.2008.12.030)
- [L3] Addressing misconceptions about de Quervain's tenosynovitis in terms of the consequences for patients and how long their symptoms will last should allow patients to make informed decisions about the treatment that best matches their values. [3] (10.1097/corr.0000000000001577)
- [L4] 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. [4] (10.1007/s12306-018-0585-1)
- [L3] The practice of obtaining routine wrist radiography prior to surgeon evaluation is wasteful as patients do not benefit from the resulting radiologic data. [5] (10.1055/s-0037-1606124)
- [L4] Providers should remain cognizant that patients presenting with de Quervain's tenosynovitis may favor initial nonsurgical management. [6] (10.1016/j.jhsg.2024.01.009)
- [L4] The authors believe the technique gives satisfactory medium-term results and should be considered part of the surgical treatment for de Quervain tenosynovitis. [7] (10.1055/s-0035-1556862)
- [L4] If diagnostic maneuvers for de Quervain tenosynovitis produce pain in a location other than the radial styloid, advanced imaging should be considered to identify other anatomic causes for the pain. [8] (10.1016/j.jhsa.2014.09.024)
- [L4] The results suggest that de Quervain's syndrome in a proportion of patients could be secondary to underlying wrist pathology due to previous trauma. [9] (10.1177/1758998315599796)
- [L4] Post-traumatic de Quervain's syndrome is very uncommon and often overlooked initially due to its rarity, but once diagnosed is typically successfully treated non-operatively. [10] (10.1177/1753193416646722)
- [L4] Though considered as a manifestation of de Quervain's disease by some authors, styloid abnormalities do not affect the outcome of management as proved in this study. [11] (10.1007/s11552-010-9258-8)
- [L4] The release of the first extensor compartment for refractory de Quervain's disease resulted in good clinical outcomes with minimal morbidity. [12] (10.4055/cios.2014.6.4.405)
- [L3] This study indicates that corticosteroid injections are a useful treatment for de Quervain's tenosynovitis, leading to treatment success 73.4% of the time within 2 injections. [13] (10.1177/1558944716681976)
- [L1] Corticosteroid injection with a short duration of immobilization remains the primary and effective treatment for de Quervain tenosynovitis. [14] (10.1016/j.jhsa.2024.03.003)
- [L4] In cases with symptoms of de Quervain's syndrome where the constriction involves only the extensor pollicis brevis in a separate compartment, exploration of both compartments is advised. [15] (10.2106/00004623-194931040-00019)
- [L4] The presence of a septum does not significantly affect clinical outcomes or complications following endoscopic release for de Quervain's syndrome. [17] (10.1177/17531934231214137)
- [L3] More negative perceptions of the consequences of de Quervain's tenosynovitis and worse pain catastrophizing are associated with worse pain and reduced function at baseline in patients awaiting surgical decompression of de Quervain's tenosynovitis. [18] (10.1097/corr.0000000000000992)
- [L4] Patients who scored lower than 40 for physical function or higher than 60 for pain interference had significantly increased odds of eventually undergoing surgical release for de Quervain tenosynovitis. [19] (10.1016/j.jhsa.2023.07.005)
- [L2] Although the success rate for the treatment of De Quervain's tenosynovitis decreases with multiple injections, repeat injections have a high rate of success and are a viable clinical option. [20] (10.1016/j.jhsa.2021.04.018)
- [L4] Patients with diabetes mellitus have a decreased probability of success following a single corticosteroid injection for de Quervain tenosynovitis in comparison to nondiabetic patients, but the effectiveness of each additional injection does not appear to diminish. [21] (10.1016/j.jhsa.2022.02.018)
- [L1] One or two local injections of 1 ml triamcinolonacetonide 10 mg/ml provided by general practitioners leads to improvement in the short term in participants with de Quervain's tenosynovitis when compared to placebo. [22] (10.1186/1471-2474-10-131)
- [L4] Endoscopic release of the extensor compartment seems to be an effective and safe procedure in patients with de Quervain's disease who are unresponsive to nonoperative treatments, despite a little increase in operation time. [23] (10.1016/j.bjps.2011.05.015)
- [L1] Pain and clinical outcomes significantly improved after corticosteroid injection in de Quervain's disease. [24] (10.1016/j.otsr.2019.11.015)
- [L1] Endoscopic release for de Quervain's tenosynovitis seems to provide earlier improvement after surgery, with fewer superficial radial nerve complications and greater scar satisfaction, when compared with open release. [25] (10.1302/0301-620x.95b7.31486)
- [L4] Most informed patients initially elect symptomatic treatment for de Quervain's disease, and most experience symptom resolution within one year. [26] (10.1007/s12593-009-0018-3)
- [L1] The efficacy of corticosteroid injections for de Quervain's tenosynovitis has been studied in only one small controlled clinical trial, which found steroid injections to be superior to thumb spica splinting. [27] (10.1002/14651858.cd005616.pub2)
- [L3] This finding may question the validity of using the asymptomatic thumb as a standard measure to identify the symptomatic thumb's impairments associated with de Quervain's disease. [28] (10.1197/j.jht.2008.03.004)
- [L5] Ultrasound is a useful imaging technique for diagnosing de Quervain's disease and provides important information about anatomic variations within the first extensor compartment. [29] (10.1136/bcr-2021-242173)
- [L4] Ultrasound is a worthwhile preoperative investigation in case of de Quervain's disease. [30] (10.1007/s12593-009-0001-z)
- [L3] The prevalence of a septated first dorsal compartment is considerably higher than previously reported, most notably in patients with De Quervain tenosynovitis. [31] (10.1177/1558944718810864)
- [L4] One portal endoscopic assisted release of the extensor compartment is an effective and safe minimal invasive procedure with similar complication rates reported previously in open and endoscopic procedures in patients with de Quervain's disease who are unresponsive to non-operative treatments. [32] (10.1016/j.aott.2018.10.004)
- [L4] In vivo EPB tendon excursion measures have been quantified, and wrist position has been found to have an influence on excursion. [33] (10.1016/j.jht.2017.12.004)
- [L4] Ultrasound-guided percutaneous release in de Quervain's disease is a safe and reliable procedure without specific morbidity. [34] (10.1055/s-0039-1678688)
- [L4] When it does, particularly in patients with de Quervain's disease, it is likely to reside in a subcompartment of the first dorsal compartment. [35] (10.1016/j.jhsa.2008.12.015)
- [L3] Neither heavy manual labor nor trauma could be shown to be predisposing risk factors for de Quervain's tenosynovitis. [36] (10.1186/s12891-015-0579-1)
- [L2] Risk factors for de Quervain's in our population include female gender, age greater than 40, and black race. [37] (10.1016/j.jhsa.2008.08.020)
- [L3] Those subjects demonstrate a significant decrease in maximum velocity in slow fist tasks, highlighting the need for comprehensive assessment to ascertain the full extent of functional limitations that can occur in the setting of hand pathology. [38] (10.1177/1558944717729218)
- [L2] The anatomical findings are consistent with previous studies, with an expectation to encounter the superficial branch of the radial nerve in more than 50% of patients. [45] (10.1055/s-0039-1688700)
References
[1] Surgical anatomy of the first extensor compartment: A systematic review and comparison of normal cadavers vs. De Quervain syndrome patients. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2017. DOI: 10.1016/j.bjps.2016.08.020
[2] Nonsurgical Treatment for de Quervain's Tenosynovitis. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2008.12.030
[3] Are Patient Expectations and Illness Perception Associated with Patient-reported Outcomes from Surgical Decompression in de Quervain’s Tenosynovitis?. Clinical Orthopaedics & Related Research. 2020. DOI: 10.1097/corr.0000000000001577
[4] Functional outcome of De Quervain’s tenosynovitis with longitudinal incision in surgically treated patients. MUSCULOSKELETAL SURGERY. 2019. DOI: 10.1007/s12306-018-0585-1
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