De-Quervain's Tenosynovitis

 De-Quervain's Tenosynovitis 

    It is a painful condition affecting first compartment of tendons on wrist joint.Commonly female and post partum are affected. 

    Clinical signs 

    Localized swelling, 

    Tenderness along radial aspect of wrist, 

    Finkelstein's test is positive.




How can we manage this condition ?

    Non operative 

    Splinting     

    Analgesia

    Local Steroid

      Operative 

            Surgical Release if non-operative measures fail.

            (under GA/regional anaesthesia and an arm tourniquet)

                Release done using transverse or a longitudinal incision. 


What are adverse effects of a local steroid injection ?

        Infection

        Injury - Superficial branch of Radial Nerve

        Tendon Rupture



Pitfalls of surgery 

        failure to recognize anatomical variation (EPB lies on a separate compartment )

        Incomplete relief of symptoms

        Painful Neuroma- injury to superficial branch of radial nerve. 




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