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Long-term results of surgical release of de Quervain’s stenosing tenosynovitis

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Abstract

The management of de Quervain’s disease (DD) is nonoperative in the first instance, but surgery should be considered if conservative measures fail. We present the long-term results of operative treatment of DD. From July 1988 to July 1998, 94 consecutive patients with DD were treated operatively by a single surgeon. There were 80 women and 14 men. Average age at the time of operation was 47.4 years (range 22–76). The right wrist was involved in 43 cases, the left in 51 cases. All operations were done under tourniquet control with local infiltration anaesthesia using a longitudinal incision and partial resection of the extensor ligament. There were six perioperative complications, including one superficial wound infection, one delayed wound healing, and four transient lesions of the radial nerve. A successful outcome was achieved in all cases with negative Finkelstein’s test. Simple decompression of both tendons and partial resection of the extensor ligament with a maximum of 3 mm can be recommended in operative treatment of DD with excellent long-term results.

Résumé

Le traitement de la maladie de de Quervain (DD) est un traitement non opératoire en première intention, néanmoins la chirurgie peut être nécessaire en cas d’échec. Nous présentons les résultats à long terme du traitement chirurgical de la maladie de De Quervain, de juillet 1988 à juillet 1998, 94 patients consécutifs présentant une maladie de De Quervain ont été traités chirurgicalement par un seul chirurgien. Il s’agissait de 80 femmes et de 14 hommes., l’âge moyen à l’intervention était de 47,4 ans (de 22 à 76). Le poignet droit était atteint dans 43 cas et le poignet gauche dans 51 cas. Toutes les opérations ont été conduites avec un garrot et une anesthésie locale, le traitement ayant constitué en une incision longitudinale permettant une résection partielle du ligament extenseur. Il y a eu 6 complications peri-opératoires incluant une infection superficielle, un retard de cicatrisation et 4 lésions transitoires du nerf radial. Un bon résultat a été observé dans tous les cas avec un test de Finkelstein négatif. La simple décompression des tendons et la résection partielle au maximum de 3 mm du retinaculum dorsal du carpe permet d’avoir un bon résultat et peut être recommandé dans le traitement des maladies de De Quervain avec une excellent résultat à long terme.

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Correspondence to Alexander Schuh.

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Scheller, A., Schuh, R., Hönle, W. et al. Long-term results of surgical release of de Quervain’s stenosing tenosynovitis. International Orthopaedics (SICOT) 33, 1301–1303 (2009). https://doi.org/10.1007/s00264-008-0667-z

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  • DOI: https://doi.org/10.1007/s00264-008-0667-z

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